Provider Demographics
NPI:1174708911
Name:JOHNSON-LOVETT, QUARTRINA (MSOT, OTR/L, OTD)
Entity type:Individual
Prefix:DR
First Name:QUARTRINA
Middle Name:
Last Name:JOHNSON-LOVETT
Suffix:
Gender:F
Credentials:MSOT, OTR/L, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 ALDEN LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38703-7842
Mailing Address - Country:US
Mailing Address - Phone:662-378-5448
Mailing Address - Fax:
Practice Address - Street 1:1549 ALDEN LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703-7842
Practice Address - Country:US
Practice Address - Phone:662-695-0406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT1561225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist