Provider Demographics
NPI:1457688525
Name:THOMPSON, JULIE A (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:SPAULDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:104 TANNDA ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS NATIONAL PARK
Mailing Address - State:AR
Mailing Address - Zip Code:71913-2546
Mailing Address - Country:US
Mailing Address - Phone:501-590-6852
Mailing Address - Fax:
Practice Address - Street 1:1807 W MOLINE ST
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-2645
Practice Address - Country:US
Practice Address - Phone:870-917-7806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTA562224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR178519721Medicaid