Provider Demographics
NPI:1588704647
Name:ANDERSEN, JULIE K (OTR/L)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:KAPLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2800 E BROADWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-5310
Mailing Address - Country:US
Mailing Address - Phone:602-234-3941
Mailing Address - Fax:
Practice Address - Street 1:2830 W GLENDALE AVE
Practice Address - Street 2:SUITE 28
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-8400
Practice Address - Country:US
Practice Address - Phone:602-234-3941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3406225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ818195Medicaid
AZ919996Medicaid