Provider Demographics
NPI:1639242498
Name:FREEMAN, JULIE ANDREA (OTR)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANDREA
Last Name:FREEMAN
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 1:11412 NIAGARA DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-4073
Mailing Address - Country:US
Mailing Address - Phone:317-577-8899
Mailing Address - Fax:317-577-8829
Practice Address - Street 1:11412 NIAGARA DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-4073
Practice Address - Country:US
Practice Address - Phone:317-577-8899
Practice Address - Fax:317-577-8829
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002353A225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics