Provider Demographics
NPI:1801891445
Name:ERB, JULIE DENICIA (OTR)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:DENICIA
Last Name:ERB
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 1:432 OAK ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-2522
Mailing Address - Country:US
Mailing Address - Phone:940-549-0788
Mailing Address - Fax:940-549-0788
Practice Address - Street 1:432 OAK ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-2522
Practice Address - Country:US
Practice Address - Phone:940-549-0788
Practice Address - Fax:940-549-0788
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104500225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004884501Medicaid