Provider Demographics
NPI:1902985070
Name:MCKENZIE, JULIE BROOKE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:BROOKE
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-1651
Mailing Address - Country:US
Mailing Address - Phone:239-596-6698
Mailing Address - Fax:
Practice Address - Street 1:929 NOTTINGHAM DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-1651
Practice Address - Country:US
Practice Address - Phone:239-596-6698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 9443225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics