Provider Demographics
NPI:1114983368
Name:ENSLIN, JULIE ANN (OTR)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:ENSLIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 GLADSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-2140
Mailing Address - Country:US
Mailing Address - Phone:608-206-0049
Mailing Address - Fax:
Practice Address - Street 1:2801 COHO ST STE 3000
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-4574
Practice Address - Country:US
Practice Address - Phone:608-273-4434
Practice Address - Fax:608-273-3426
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3026-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist