Individual
KATHLEEN RHODA JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1606 HUNT DR, NORMAL, IL 61761-2192
(309) 452-8888
Mailing address
9 EBACH DR, BLOOMINGTON, IL 61701-2005
(309) 830-8513
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008387
IL
Other
Enumeration date
06/05/2017
Last updated
06/05/2017
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