Provider Demographics
NPI:1801424361
Name:DUFFY, JULIAH MARIE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:JULIAH
Middle Name:MARIE
Last Name:DUFFY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 TWIN RIVERS BLVD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-5112
Mailing Address - Country:US
Mailing Address - Phone:407-451-0089
Mailing Address - Fax:
Practice Address - Street 1:4875 PALM COAST PKWY NW UNIT 2
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3671
Practice Address - Country:US
Practice Address - Phone:386-446-9935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20256225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist