Provider Demographics
NPI:1558538538
Name:VERMAELEN, JULIE (OT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:VERMAELEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6112 YOHO DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-2743
Mailing Address - Country:US
Mailing Address - Phone:318-443-9305
Mailing Address - Fax:318-443-3143
Practice Address - Street 1:6112 YOHO DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-2743
Practice Address - Country:US
Practice Address - Phone:318-443-9305
Practice Address - Fax:318-443-3143
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200030225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist