Provider Demographics
NPI:1780437764
Name:VERSTANDIG, JULIANNA ROSE (MOTR/L)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:ROSE
Last Name:VERSTANDIG
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6446 DRESDEN PL
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-7671
Mailing Address - Country:US
Mailing Address - Phone:443-315-7840
Mailing Address - Fax:
Practice Address - Street 1:6446 DRESDEN PL
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-7671
Practice Address - Country:US
Practice Address - Phone:443-315-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07336225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist