Provider Demographics
NPI:1477052165
Name:BARLA, JULIANA (CTRS)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:BARLA
Suffix:
Gender:F
Credentials:CTRS
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 1053
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-1053
Mailing Address - Country:US
Mailing Address - Phone:616-828-5492
Mailing Address - Fax:855-207-3270
Practice Address - Street 1:4934 LUXEMBURG ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8406
Practice Address - Country:US
Practice Address - Phone:616-828-5492
Practice Address - Fax:855-207-3270
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty