Individual
CAROL L JOHNSON
Active
Individual
CAROL L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
0602
NC
225X00000X
Occupational Therapist
Primary
0602
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0443M
BCBS NC DME
NC
01
—
12411
BLUE CROSS BLUE SHIELD NC
NC
01
—
5621622071
TRICARE
NC
Enumeration date
05/02/2007
Last updated
10/20/2008
Update your record
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