Basic Information
| Provider Information | |||||||||
| NPI: | 1699973065 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRANE | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OTR/L, MBA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | COORS | ||||||||
| OtherFirstName: | JULIE | ||||||||
| OtherMiddleName: | LOUISE | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | OTR/L, MBA | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 13537 BARRETT PARKWAY DRIVE | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | BALLWIN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630215866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3148219126 | ||||||||
| FaxNumber: | 3148219142 | ||||||||
| Practice Location | |||||||||
| Address1: | 951 WATERBURY FALLS DRIVE | ||||||||
| Address2: | |||||||||
| City: | O'FALLON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 633682202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6363360300 | ||||||||
| FaxNumber: | 6363360297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2007 | ||||||||
| LastUpdateDate: | 10/21/2009 | ||||||||
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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 | 225XN1300X | 004192 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Neurorehabilitation |
No ID Information.