Janice Kay Gabriel Johnson, OTRL

Individual provider Active NPI Occupational Therapist · Valley City, ND

NPI 1104000124 · NPPES record last updated May 31, 2023

Key facts

NPI
1104000124
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
756 (ND)
Practice address
744 8TH Ave NW
Valley City, ND 58072-2000
Phone
(701) 840-0079
NPI assigned
Dec 27, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
756NDMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 756 ND Yes

Addresses

Primary practice location

744 8TH Ave NW
Valley City, ND 58072-2000

Mailing address

744 8TH Ave NW
Valley City, ND 58072
Phone (701) 845-5834

Other identifiers

IdentifierTypeStateIssuer
30517OtherNDBC/BS
55185MedicaidND

Other providers in Valley City, ND

All providers in Valley City, ND · Occupational Therapist in North Dakota

Sources for this page

Verify at the official NPI Registry.