Kelli Johnson, MOTR/L

Individual provider Active NPI Occupational Therapist · North Mankato, MN

NPI 1013429307 · NPPES record last updated Oct 26, 2017

Key facts

NPI
1013429307
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
105404 (MN)
Practice address
1575 Hoover Dr
North Mankato, MN 56003-2667
Phone
(507) 387-2037
NPI assigned
Oct 26, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
105404MNMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 105404 MN Yes

Addresses

Primary practice location

1575 Hoover Dr
North Mankato, MN 56003-2667

Mailing address

16 Snowbird CT
North Mankato, MN 56003-1637
Phone (507) 317-1814

Other providers in North Mankato, MN

All providers in North Mankato, MN · Occupational Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.