Provider Demographics
NPI:1821342254
Name:JOHNSTON, JULIE (OT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71-77 OKNER PKWY
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1629
Mailing Address - Country:US
Mailing Address - Phone:973-535-1999
Mailing Address - Fax:973-535-1268
Practice Address - Street 1:71-77 OKNER PKWY
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1629
Practice Address - Country:US
Practice Address - Phone:973-535-1999
Practice Address - Fax:973-535-1268
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00397500225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist