Provider Demographics
NPI:1689382087
Name:DEW, JULIA MARGARET (LMT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:MARGARET
Last Name:DEW
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:DEW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14206 DOVE CREEK WAY UNIT 201
Mailing Address - Street 2:
Mailing Address - City:SPARKS GLENCOE
Mailing Address - State:MD
Mailing Address - Zip Code:21152-8890
Mailing Address - Country:US
Mailing Address - Phone:410-585-5725
Mailing Address - Fax:
Practice Address - Street 1:14206 DOVE CREEK WAY UNIT 201
Practice Address - Street 2:
Practice Address - City:SPARKS GLENCOE
Practice Address - State:MD
Practice Address - Zip Code:21152-8890
Practice Address - Country:US
Practice Address - Phone:410-585-5725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM03420225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty