Provider Demographics
NPI:1205183274
Name:FLAHERTY, JULIE ANNA (MPT)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNA
Last Name:FLAHERTY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANNA
Other - Last Name:SHAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 179
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-0179
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4105 NORRISVILLE RD UNIT 7
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:MD
Practice Address - Zip Code:21161-9308
Practice Address - Country:US
Practice Address - Phone:410-692-2941
Practice Address - Fax:410-692-6073
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist