National Provider Identifier
Jacqueline M Johnson, OTR/L
Jacqueline M Johnson, OTR/L is listed in the NPPES registry with a primary specialty of Occupational Therapist in Spencerport, NY and a listed phone number of (585) 349-5140.
Profile Overview
- NPI
- 1801980032
- Provider Type
- Individual
- Primary Specialty
- Occupational Therapist
- Enumeration Date
- October 03, 2006
- Last Updated
- June 22, 2011
Practice Location
- 71 Lyell Ave
- Spencerport, NY 14559-1825
Phone: (585) 349-5140
Specialties
- Occupational Therapist (225X00000X)
Full Record
- NPI
- 1801980032
- Entity Type
- Individual
- Last Name
- Johnson
- First Name
- Jacqueline
- Middle Name
- M
- Name Prefix
- Mrs.
- Credential
- OTR/L
- Provider Other Last Name
- Jorgensen
- Provider Other First Name
- Jacqueline
- Provider Other Middle Name
- M
- Provider Other Name Prefix Text
- Miss
- Provider Other Credential Text
- OTR/L
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 71 Lyell Ave
- Mailing City
- Spencerport
- Mailing State
- NY
- Mailing ZIP Code
- 14559-1825
- Mailing Country
- US
- Mailing Phone
- (585) 349-5140
- Practice Street Address
- 71 Lyell Ave
- Practice City
- Spencerport
- Practice State
- NY
- Practice ZIP Code
- 14559-1825
- Practice Country
- US
- Practice Phone
- (585) 349-5140
- Enumeration Date
- October 03, 2006
- Last Updated
- June 22, 2011
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Occupational Therapist (225X00000X)
- Other Identifiers
- 30-0213081 (NY, Tax Id)