Provider Demographics
NPI:1710903109
Name:EDER, JULIA C (OTRL)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:C
Last Name:EDER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
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Mailing Address - Street 1:360 SHERMAN ST
Mailing Address - Street 2:SUITE 470
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2564
Mailing Address - Country:US
Mailing Address - Phone:651-209-6520
Mailing Address - Fax:651-209-6521
Practice Address - Street 1:360 SHERMAN ST
Practice Address - Street 2:SUITE 470
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2564
Practice Address - Country:US
Practice Address - Phone:651-209-6520
Practice Address - Fax:651-209-6521
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2010-05-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN102815225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2160148OtherAMERICAS PPO/ARAZ
MNA008OtherTRICARE
MN851S1ROOtherBCBS OF MN
MN6404814OtherMEDICA CHOICE/SELECT CARE
MN167565F703OtherUCARE
MN509491028653OtherPREFERRED ONE INSURANCE
MN6401989OtherMEDICA PRIMARY
MNHP42856OtherHEALTH PARTNERS
MNP00150739Medicare PIN
MN6401989OtherMEDICA PRIMARY
MNA008OtherTRICARE
MN851S1ROOtherBCBS OF MN