Healthcare Provider Details

I. General information

NPI: 1053527697
Provider Name (Legal Business Name): JULIANN HANSON OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2373 G RD STE 100
GRAND JUNCTION CO
81505-1003
US

IV. Provider business mailing address

37236 FOREST TRL
ELIZABETH CO
80107-8108
US

V. Phone/Fax

Practice location:
  • Phone: 970-245-0484
  • Fax:
Mailing address:
  • Phone: 303-902-8476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0001903
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: