Provider Demographics
NPI:1891018917
Name:JAMES MADISON UNIVERSITY
Entity Type:Organization
Organization Name:JAMES MADISON UNIVERSITY
Other - Org Name:JMU OCCUPATIONAL THERAPY CLINICAL EDUCATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BONHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:540-568-4980
Mailing Address - Street 1:JMU MSC 9022
Mailing Address - Street 2:755 MLK JR. WAY
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-0001
Mailing Address - Country:US
Mailing Address - Phone:540-568-7749
Mailing Address - Fax:540-568-6409
Practice Address - Street 1:131 W GRACE ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22807-0001
Practice Address - Country:US
Practice Address - Phone:540-568-7749
Practice Address - Fax:540-568-6409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty