Individual
JULIE LIEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18285 E 10 MILE RD, STE.100, ROSEVILLE, MI 48066-5802
(586) 774-5774
(586) 774-5884
Mailing address
13840 KAHLA DR, BELLEVILLE, MI 48111-1033
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201003175
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
670H202840
BCBS
MI
01
—
670H215940
BCBS
MI
01
—
P00081958
RAILROAD
MI
01
—
P00363458
RAILROAD
MI
Enumeration date
07/22/2006
Last updated
07/20/2011
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