Provider Demographics
NPI:1992838940
Name:HICKIN, JULIE MARIE (OTRL)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:MARIE
Last Name:HICKIN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:MARIE
Other - Last Name:HICKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTRL
Mailing Address - Street 1:6520 PITTS BLVD
Mailing Address - Street 2:APT 321
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-3146
Mailing Address - Country:US
Mailing Address - Phone:440-233-1000
Mailing Address - Fax:
Practice Address - Street 1:1800 LIVINGSTON AVE
Practice Address - Street 2:BLDG C
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-3781
Practice Address - Country:US
Practice Address - Phone:440-233-1070
Practice Address - Fax:440-233-1056
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT 005738225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand