Provider Demographics
NPI:1972826857
Name:HENDRIX, JULIE RENEE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:RENEE
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 S JACKSON PARK DR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2627
Mailing Address - Country:US
Mailing Address - Phone:812-522-6049
Mailing Address - Fax:812-522-6371
Practice Address - Street 1:707 S JACKSON PARK DR
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2627
Practice Address - Country:US
Practice Address - Phone:812-522-6049
Practice Address - Fax:812-522-6371
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003750A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist