Provider Demographics
NPI:1336384049
Name:THORNTON, JULIE KRISTINE (OTD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:KRISTINE
Last Name:THORNTON
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:KRISTINE
Other - Last Name:BLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15301 W. 87TH ST #200
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219
Mailing Address - Country:US
Mailing Address - Phone:402-660-4755
Mailing Address - Fax:
Practice Address - Street 1:10300 INDIAN CREEK PARKWAY
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210
Practice Address - Country:US
Practice Address - Phone:913-652-9229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1702506225X00000X
IN31004411A225X00000X
MO2008028709225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist