Individual
SARA N JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1410 LONG RUN RD, LOUISVILLE, KY 40245-4334
(502) 244-8011
(502) 244-6631
Mailing address
1410 LONG RUN RD, LOUISVILLE, KY 40245-4334
(502) 244-8011
(502) 244-6631
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
132067
KY
225X00000X
Occupational Therapist
31005038A
IN
225X00000X
Occupational Therapist
R4085
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000601542
ANTHEM
KY
01
—
50026124
PASSPORT
KY
05
—
7100085590
—
KY
Enumeration date
01/15/2009
Last updated
05/26/2016
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