Provider Demographics
NPI:1518630771
Name:ROSALES, JULIUS R (OT)
Entity Type:Individual
Prefix:MR
First Name:JULIUS
Middle Name:R
Last Name:ROSALES
Suffix:
Gender:M
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 791217
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-1217
Mailing Address - Country:US
Mailing Address - Phone:301-932-4785
Mailing Address - Fax:301-932-4789
Practice Address - Street 1:3320 CRAIN HWY STE 205
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4850
Practice Address - Country:US
Practice Address - Phone:301-870-7366
Practice Address - Fax:301-870-6717
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT01217225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty