Provider Demographics
NPI:1659607679
Name:JOHNSON, LAURIE ANNE (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:ANNE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2061 PEACHTREE RD, NE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1446
Mailing Address - Country:US
Mailing Address - Phone:404-352-3522
Mailing Address - Fax:865-932-1374
Practice Address - Street 1:620 CHEROKEE STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060
Practice Address - Country:US
Practice Address - Phone:770-795-7979
Practice Address - Fax:865-932-1374
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4117225X00000X
GA006251225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist