Provider Demographics
NPI:1598979783
Name:FERRIS, JULIE LYNN (OTR)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:LYNN
Last Name:FERRIS
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 1:10337 GLADEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-8603
Mailing Address - Country:US
Mailing Address - Phone:317-965-4843
Mailing Address - Fax:317-894-9425
Practice Address - Street 1:10337 GLADEVIEW DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-8603
Practice Address - Country:US
Practice Address - Phone:317-965-4843
Practice Address - Fax:317-894-9425
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003603A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist