Provider Demographics
NPI:1831127299
Name:BIRDSONG, JULIE C (COTA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:BIRDSONG
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:C
Other - Last Name:PATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7211 W 110TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2339
Mailing Address - Country:US
Mailing Address - Phone:913-451-7372
Mailing Address - Fax:913-451-7375
Practice Address - Street 1:7211 W 110TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2339
Practice Address - Country:US
Practice Address - Phone:913-451-7372
Practice Address - Fax:913-451-7375
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-00217224Z00000X
MO004127224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant