Provider Demographics
NPI:1740812692
Name:ARNOLD, JULIE DANIELLE (COTA)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:DANIELLE
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:DANIELLE
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:428 RIVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHURCH HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37642-4608
Mailing Address - Country:US
Mailing Address - Phone:423-480-0562
Mailing Address - Fax:
Practice Address - Street 1:100 NETHERLAND LN
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-7245
Practice Address - Country:US
Practice Address - Phone:423-245-0360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-09
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3078224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant