Basic Information
| Provider Information | |||||||||
| NPI: | 1437253945 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEGROFF | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2483 N STRAWBERRY WAY | ||||||||
| Address2: | |||||||||
| City: | FLAGSTAFF | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 860047614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9286000170 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3150 N WINDING BROOK RD | ||||||||
| Address2: | |||||||||
| City: | FLAGSTAFF | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 860010972 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287747106 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 10/01/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 3974 | AZ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 056.003789 | IL | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.