MEDICARE: MRS. JULIE LEE MURRAY M.O.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XF0002X	Feeding, Eating & Swallowing Occupational Therapist	4269	CA
2	225XP0200X	Pediatric Occupational Therapist	4269	CA

General Provider Information

NPI Number	:	1053603589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE LEE MURRAY M.O.T.

Provider Business Mailing Address
First Line	:	1159 ELFIN FOREST RD E
Second Line	:
City	:	SAN MARCOS
State	:	CA
Zip	:	92078-1077
Country	:	US
Telephone Number	:	858-349-3886
Fax Number	:

Provider Business Practice Location Address
First Line	:	1159 ELFIN FOREST RD E
Second Line	:
City	:	SAN MARCOS
State	:	CA
Zip	:	92078-1077
Country	:	US
Telephone Number	:	858-349-3886
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2011
Last Update Date	:	05/03/2011

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