Healthcare Provider Details

I. General information

NPI: 1437614401
Provider Name (Legal Business Name): JULIE DEANNE ANDERSON-SEIDENS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2019
Last Update Date: 02/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15820 ADDISON RD
ADDISON TX
75001-3549
US

IV. Provider business mailing address

6415 MEADOWCREST LN
SACHSE TX
75048-5515
US

V. Phone/Fax

Practice location:
  • Phone: 214-575-2999
  • Fax: 972-364-1256
Mailing address:
  • Phone: 682-351-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number119666
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: