Provider Demographics
NPI:1568533420
Name:NEAL, JULIE A (OTR/L , COTA)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:NEAL
Suffix:
Gender:F
Credentials:OTR/L , COTA
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:346 PRIVATE ROAD 2313 # 12
Mailing Address - Street 2:
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669-8140
Mailing Address - Country:US
Mailing Address - Phone:304-939-1932
Mailing Address - Fax:740-451-0854
Practice Address - Street 1:346 PRIVATE ROAD 2313 # 12
Practice Address - Street 2:
Practice Address - City:PROCTORVILLE
Practice Address - State:OH
Practice Address - Zip Code:45669-8140
Practice Address - Country:US
Practice Address - Phone:304-939-1932
Practice Address - Fax:740-451-0854
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R3210225X00000X
WV989225X00000X
OHOT.005883225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9640341OtherAETNA
NE4240771OtherMEDICARE
WV7503045000Medicaid