Johnson, Kelly Renee
Johnson, Kelly Renee is an individual health care provider with primary practice located at 2422 Partridge Loop , Post Falls ID 83854-4944. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Johnson, Kelly Renee can be contacted via phone (208) 819-9363.Contact Information
Primary practice address
2422 Partridge Loop
Post Falls ID 83854-4944
Phone: (208) 819-9363
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 553 | South Dakota |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | OT-840 | Idaho |
Profile Details
| NPI number | 1760501993 |
|---|---|
| LBN Legal business name | Johnson, Kelly Renee |
| Credentials | MAOTRL |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 28th, 2007 |
| Last updated | Jul 31st, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760501993 | NPPES |
| South Dakota | MEDICAID | 5834280 |
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