Provider Demographics
NPI:1831815026
Name:JOHNSON, ASHLEE (OTR/L)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3552 W HONDA AVE
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-1606
Mailing Address - Country:US
Mailing Address - Phone:385-227-9086
Mailing Address - Fax:
Practice Address - Street 1:527 W 400 N STE 6
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-1951
Practice Address - Country:US
Practice Address - Phone:801-714-3366
Practice Address - Fax:801-714-3227
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12874632-4201225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation