Provider Demographics
NPI:1740251768
Name:JOHNSON, SUSAN FRANCES (OTR)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:FRANCES
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 836
Mailing Address - Street 2:BOX 385
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09636
Mailing Address - Country:IT
Mailing Address - Phone:0113909-530-6874
Mailing Address - Fax:
Practice Address - Street 1:PSC 836
Practice Address - Street 2:BOX 385
Practice Address - City:FPO AE
Practice Address - State:ITALY
Practice Address - Zip Code:09636
Practice Address - Country:IT
Practice Address - Phone:01103909-530-6874
Practice Address - Fax:0113909-530-6874
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-28
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT360225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist