Julie Goggins Brazil, OCCUPATIONAL THERAPI
Individual provider Active NPI Occupational Therapist · Ward, AR
NPI 1720128762 · NPPES record last updated Nov 8, 2023
Key facts
- NPI
- 1720128762
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OTR503 (AR)
- Practice address
- 1500 Wilson Loop
Ward, AR 72176 - Phone
- (501) 941-5630
- NPI assigned
- Feb 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTR503 | AR | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allied Therapy and Consulting Services, PA | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTR503 | AR | Yes |
Addresses
Primary practice location
1500 Wilson Loop
Ward, AR 72176
Mailing address
1434 Fern Creek Circle
Benton, AR 72019-9609
Phone (501) 772-6667
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120324721 | Medicaid | AR | |
| 5X311 | Other | AR | BLUE CROSS BLUE SHIELD |
| OTR503 | Medicaid | AR |
Other names
- Julie Goggins Sobkoviak
Other providers in Ward, AR
- Beyond Boundaries, Inc
- Alicia Billings
- Amanda Bobo
- Alexis Boster
- William Brian Brady
- Jennifer Brooke Bricker
- Kari Bridges
- Jaylin Brock
- Katie Burleson
- Kathy Burnette
All providers in Ward, AR · Occupational Therapist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.