Basic Information
| Provider Information | |||||||||
| NPI: | 1821361403 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAGLE | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.O.T., OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 108 FRANCISCAN WAY | ||||||||
| Address2: | |||||||||
| City: | LORETTO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159409703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144723639 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 108 FRANCISCAN WAY | ||||||||
| Address2: | |||||||||
| City: | LORETTO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159409703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144723936 | ||||||||
| FaxNumber: | 8144723905 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2012 | ||||||||
| LastUpdateDate: | 06/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC009453 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.