Provider Demographics
NPI:1386882850
Name:WOODARD, JULIA M (OTR, CART, EAS)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:M
Last Name:WOODARD
Suffix:
Gender:F
Credentials:OTR, CART, EAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4116 S CARRIER PKWY
Mailing Address - Street 2:SUITE 280-828
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3200
Mailing Address - Country:US
Mailing Address - Phone:972-816-0909
Mailing Address - Fax:972-642-4999
Practice Address - Street 1:4116 S CARRIER PKWY
Practice Address - Street 2:SUITE 280-828
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3200
Practice Address - Country:US
Practice Address - Phone:972-816-0909
Practice Address - Fax:972-642-4999
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
TX102004225XE1200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics