Provider Demographics
NPI:1780774158
Name:BREWER, JULIE LEIGH (COTA)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LEIGH
Last Name:BREWER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-6563
Mailing Address - Country:US
Mailing Address - Phone:931-766-9759
Mailing Address - Fax:
Practice Address - Street 1:374 BRINK ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-3280
Practice Address - Country:US
Practice Address - Phone:931-762-6548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN775224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant