Provider Demographics
NPI:1558486613
Name:KENNY, JULIE A (OT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:KENNY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:YEDLICKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:720 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2626
Mailing Address - Country:US
Mailing Address - Phone:615-778-4066
Mailing Address - Fax:615-778-9114
Practice Address - Street 1:5757 W THUNDERBIRD RD
Practice Address - Street 2:SUITE E-465
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4641
Practice Address - Country:US
Practice Address - Phone:602-843-9945
Practice Address - Fax:602-843-8775
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2586225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist