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General NPI Number Information
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NPI Number | 1992915409
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Entity Type | Individual
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Provider Name | JULIANNE PATRICIA BRASWELL O.T.R.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 01/14/2017
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Provider Practice Location Address
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Address Line | 4301 GREATHOUSE SPRINGS ROAD
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City | JOHNSON
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State | AR
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Zip | 72741
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Country | US
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Telephone | 479-200-6555
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Fax |
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Provider Business Mailing Address
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Address Line | 5501 WILLOW CREEK DR STE 105
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City | SPRINGDALE
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State | AR
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Zip | 72762-8707
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Country | US
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Telephone | 479-575-9359
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Fax | 479-575-9415
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OTR1338
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License Number State | AR
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