Individual
JULIANA LEE DURRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
8711 VILLAGE DR, SUITE 109, SAN ANTONIO, TX 78217-5418
(210) 297-2725
(210) 297-0215
Mailing address
6467 LOST HOLLY, SAN ANTONIO, TX 78240-4940
(210) 561-1380
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109491
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109491
OT LICENSE
TX
01
—
PENDING
BLUE CROSS
TX
05
—
PENDING
—
TX
Enumeration date
06/14/2006
Last updated
05/08/2012
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