Provider Demographics
NPI:1992915409
Name:BRASWELL, JULIANNE PATRICIA (OTR)
Entity type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:PATRICIA
Last Name:BRASWELL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 WILLOW CREEK DR
Mailing Address - Street 2:STE 105
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-8707
Mailing Address - Country:US
Mailing Address - Phone:479-575-9359
Mailing Address - Fax:479-575-9415
Practice Address - Street 1:4301 GREATHOUSE SPRINGS ROAD
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:AR
Practice Address - Zip Code:72741
Practice Address - Country:US
Practice Address - Phone:479-200-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1338225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR143862721Medicaid