Provider Demographics
NPI:1154528800
Name:JOHNSON, HEATHER (OTD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841-2040
Mailing Address - Country:US
Mailing Address - Phone:603-703-3136
Mailing Address - Fax:
Practice Address - Street 1:235 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03841-2040
Practice Address - Country:US
Practice Address - Phone:603-703-3136
Practice Address - Fax:603-703-3136
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1571225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist