Provider Demographics
NPI:1841636834
Name:HESKIN, JULIE IRENE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:IRENE
Last Name:HESKIN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:768 W CALLE LA BOLITA
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8658
Mailing Address - Country:US
Mailing Address - Phone:520-730-6231
Mailing Address - Fax:
Practice Address - Street 1:768 W CALLE LA BOLITA
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-8658
Practice Address - Country:US
Practice Address - Phone:520-730-6231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5485224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant