Provider Demographics
NPI:1851602262
Name:BIRCH, JULIE MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:BIRCH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MARIE
Other - Last Name:SENN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5777 WATERBURY CIR
Mailing Address - Street 2:UNIT L
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1150
Mailing Address - Country:US
Mailing Address - Phone:801-884-6378
Mailing Address - Fax:
Practice Address - Street 1:500 FOOTHILL DR
Practice Address - Street 2:GEORGE E. WHALEN VETERAN'S AFFAIRS
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84148-0001
Practice Address - Country:US
Practice Address - Phone:801-582-1565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT77018504201225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist