Healthcare Provider Details

I. General information

NPI: 1578046199
Provider Name (Legal Business Name): JULIA LEBLANC HOHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 BRANSON LANDING BLVD
BRANSON MO
65616-2074
US

IV. Provider business mailing address

772 NOTTING HILL GATE
NIXA MO
65714-7701
US

V. Phone/Fax

Practice location:
  • Phone: 417-332-2990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: