Provider Demographics
NPI:1255122073
Name:BUSHELMAN, JULIETTE MORGAN (OTR/L, OTD)
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:MORGAN
Last Name:BUSHELMAN
Suffix:
Gender:F
Credentials:OTR/L, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 N FORT THOMAS AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:FORT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075-1595
Mailing Address - Country:US
Mailing Address - Phone:859-441-0139
Mailing Address - Fax:
Practice Address - Street 1:18 N FORT THOMAS AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075-1595
Practice Address - Country:US
Practice Address - Phone:859-441-0139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
296631225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist