Healthcare Provider Details

I. General information

NPI: 1417009135
Provider Name (Legal Business Name): JULIE MARIE NEUMANN MA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4570 VICTORIA ST N
SHOREVIEW MN
55126-5800
US

IV. Provider business mailing address

30 19TH AVE SW
NEW BRIGHTON MN
55112-3324
US

V. Phone/Fax

Practice location:
  • Phone: 651-621-6000
  • Fax:
Mailing address:
  • Phone: 612-791-0219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number103377
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: