Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jaclyn Mae Johnson, OTD, OTR/L

Individual provider Pediatric Occupational Therapist · NPI 1710554548

Jaclyn Mae Johnson, OTD, OTR/L is a Pediatric Occupational Therapist in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2021.

Licensed in
AZ
In the registry since
2021
What do these letters mean?
OTD — Doctor of Occupational Therapy
The doctoral degree in occupational therapy.
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

6250 S 40th St Unit 4006
Phoenix, AZ 85042-5277
Phone: (612) 747-2489
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence OTH-009675 (AZ)

Record details

NPI number1710554548
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTD , OTR/L
Sole proprietorNo
NPI enumeratedJune 9, 2021
Last updated in NPPESMay 20, 2025
Certification dateMay 20, 2025

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