Provider Demographics
NPI:1265859870
Name:JOHNSON, KARLEEN (OTR/L)
Entity type:Individual
Prefix:
First Name:KARLEEN
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KARLEEN
Other - Middle Name:
Other - Last Name:KONIKOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5641 NW 38TH TER
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4130
Mailing Address - Country:US
Mailing Address - Phone:954-562-1526
Mailing Address - Fax:
Practice Address - Street 1:5641 NW 38TH TER
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4130
Practice Address - Country:US
Practice Address - Phone:954-562-1526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-20
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 16263225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist