Provider Demographics
NPI:1679245930
Name:MERCIER, JULIA MARIE (OTRL)
Entity Type:Individual
Prefix:MISS
First Name:JULIA
Middle Name:MARIE
Last Name:MERCIER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4098 3 OAKS DR APT 3B
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-4558
Mailing Address - Country:US
Mailing Address - Phone:248-416-0243
Mailing Address - Fax:
Practice Address - Street 1:165 KIRTS BLVD STE 500
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-5214
Practice Address - Country:US
Practice Address - Phone:248-486-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201011383225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist