Provider Demographics
NPI:1073827622
Name:MORK, JULI ANN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:JULI
Middle Name:ANN
Last Name:MORK
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 1:2 HARBOR BEND CT
Mailing Address - Street 2:
Mailing Address - City:LAKE ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-1478
Mailing Address - Country:US
Mailing Address - Phone:636-695-2070
Mailing Address - Fax:636-695-2080
Practice Address - Street 1:2 HARBOR BEND CT
Practice Address - Street 2:
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1478
Practice Address - Country:US
Practice Address - Phone:636-695-2070
Practice Address - Fax:636-695-2080
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002589225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist