Provider Demographics
NPI:1689328783
Name:WITTY, JULIA G
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:G
Last Name:WITTY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20602 NW 7TH CT
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2384
Mailing Address - Country:US
Mailing Address - Phone:786-704-2249
Mailing Address - Fax:
Practice Address - Street 1:3670 N 54TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-2340
Practice Address - Country:US
Practice Address - Phone:786-651-9311
Practice Address - Fax:754-201-1390
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist