Basic Information
| Provider Information | |||||||||
| NPI: | 1568116150 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SIEGEL | ||||||||
| FirstName: | JULIENNE | ||||||||
| MiddleName: | RENEE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3555 BUCKEYE TRCE | ||||||||
| Address2: | |||||||||
| City: | CLEVES | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450022389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136030469 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4320 BRIDGETOWN RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452114428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135744550 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2022 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.