Provider Demographics
NPI:1538599196
Name:BAUER, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E EVANS ST
Mailing Address - Street 2:APT P292
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-2739
Mailing Address - Country:US
Mailing Address - Phone:610-457-4219
Mailing Address - Fax:
Practice Address - Street 1:300 E EVANS ST
Practice Address - Street 2:APT P292
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2739
Practice Address - Country:US
Practice Address - Phone:610-457-4219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC013070225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist