Provider Demographics
NPI:1487023305
Name:GLUCKSMAN, JULIA ERIN (LOTR)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ERIN
Last Name:GLUCKSMAN
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10732 S MALL DR APT 1234
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-4826
Mailing Address - Country:US
Mailing Address - Phone:310-367-3436
Mailing Address - Fax:
Practice Address - Street 1:4517 LORINO ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2323
Practice Address - Country:US
Practice Address - Phone:504-723-2502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200782225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist