Provider Demographics
NPI:1063840486
Name:DRAKE, JULIE LOUISE (OTR)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LOUISE
Last Name:DRAKE
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:PO BOX 594
Mailing Address - Street 2:
Mailing Address - City:MEEKER
Mailing Address - State:CO
Mailing Address - Zip Code:81641-0594
Mailing Address - Country:US
Mailing Address - Phone:970-878-9958
Mailing Address - Fax:
Practice Address - Street 1:1110 COUNTY ROAD 43
Practice Address - Street 2:
Practice Address - City:MEEKER
Practice Address - State:CO
Practice Address - Zip Code:81641-9501
Practice Address - Country:US
Practice Address - Phone:970-878-9958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02869225X00000X
CO0002068225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist