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General NPI Number Information
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NPI Number | 1306889589
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Entity Type | Individual
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Provider Name | JULIANA LEE DURRETT OTR
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Gender | Female
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 8711 VILLAGE DR SUITE 109
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5418
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Country | US
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Telephone | 210-297-2725
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Fax | 210-297-0215
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Provider Business Mailing Address
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Address Line | 6467 LOST HOLLY
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City | SAN ANTONIO
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State | TX
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Zip | 78240-4940
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Country | US
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Telephone | 210-561-1380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 109491
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License Number State | TX
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