Healthcare Provider Details

I. General information

NPI: 1497909535
Provider Name (Legal Business Name): JULIE CHRYSTINA NEWTON MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2008
Last Update Date: 11/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 S MAIN ST
MALVERN AR
72104-5600
US

IV. Provider business mailing address

1625 S MAIN ST
MALVERN AR
72104-5600
US

V. Phone/Fax

Practice location:
  • Phone: 501-332-1816
  • Fax:
Mailing address:
  • Phone: 501-332-1816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOTR2023
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: