Provider Demographics
NPI:1942540935
Name:HUCKABEE, JULIE COLEMAN (OTR/L, MSR)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:COLEMAN
Last Name:HUCKABEE
Suffix:
Gender:F
Credentials:OTR/L, MSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 CAVALIER WAY
Mailing Address - Street 2:
Mailing Address - City:ROEBUCK
Mailing Address - State:SC
Mailing Address - Zip Code:29376-3367
Mailing Address - Country:US
Mailing Address - Phone:864-576-4212
Mailing Address - Fax:864-574-6265
Practice Address - Street 1:1390 CAVALIER WAY
Practice Address - Street 2:
Practice Address - City:ROEBUCK
Practice Address - State:SC
Practice Address - Zip Code:29376-3367
Practice Address - Country:US
Practice Address - Phone:864-576-4212
Practice Address - Fax:864-574-6265
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2440225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist