Provider Demographics
NPI:1801071816
Name:SOMMER, JULIE W (MSOT, OTR/L)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:W
Last Name:SOMMER
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25223
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00824-1223
Mailing Address - Country:US
Mailing Address - Phone:340-277-4995
Mailing Address - Fax:
Practice Address - Street 1:5030 ANCHOR WAY STE 9
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4692
Practice Address - Country:US
Practice Address - Phone:340-277-4995
Practice Address - Fax:866-411-7667
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002024065225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist