Provider Demographics
NPI:1811448186
Name:STASCHKE, JULIDE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:JULIDE
Middle Name:
Last Name:STASCHKE
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2747 ENTERPRISE AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-7412
Mailing Address - Country:US
Mailing Address - Phone:406-534-2087
Mailing Address - Fax:
Practice Address - Street 1:2747 ENTERPRISE AVE STE 5
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7412
Practice Address - Country:US
Practice Address - Phone:406-534-2087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK115395225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist