Provider Demographics
NPI:1073313540
Name:FLAKER, JULIE ROBERTSON (MSED)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ROBERTSON
Last Name:FLAKER
Suffix:
Gender:
Credentials:MSED
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ROBERTSON
Other - Last Name:MUCKINHAUPT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSED
Mailing Address - Street 1:414 PARK ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-8018
Mailing Address - Country:US
Mailing Address - Phone:716-489-8775
Mailing Address - Fax:716-484-3518
Practice Address - Street 1:414 PARK ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-8018
Practice Address - Country:US
Practice Address - Phone:716-489-8775
Practice Address - Fax:716-484-3518
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training Provider