Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XF0002X | Feeding, Eating & Swallowing | ||
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | ||
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1265755680 |
---|---|
Provider Name | Julie Ann Butler |
First Address | Longmont, CO 80504-2330 |
Second Address | Longmont, CO 80501-7407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2010 |
Last Update Date | 12/03/2010 |