Provider Demographics
NPI:1790474047
Name:JOHNSTON, VICTORIA KATE (OTD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:KATE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:997 JOHNNIE DODDS BLVD APT 217
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6114
Mailing Address - Country:US
Mailing Address - Phone:843-384-0793
Mailing Address - Fax:
Practice Address - Street 1:2333 ASHLEY RIVER RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-4755
Practice Address - Country:US
Practice Address - Phone:843-258-5538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6348225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist