Provider Demographics
NPI:1871988204
Name:SHELDON, JULIE (OT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SHELDON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 740041
Mailing Address - Street 2:DEPT 6150
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-7441
Mailing Address - Country:US
Mailing Address - Phone:502-561-4295
Mailing Address - Fax:502-562-0348
Practice Address - Street 1:4642 CHAMBERLAIN LN
Practice Address - Street 2:SUITE 202
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2156
Practice Address - Country:US
Practice Address - Phone:502-562-0344
Practice Address - Fax:502-562-0328
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004782A225X00000X
KYBOTOCT00218305225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist