Provider Demographics
NPI:1174748065
Name:WYER, JULIE S (OTR)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:S
Last Name:WYER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:SUZANNE
Other - Last Name:FREED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:733 NICKLAUS DR SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4122
Mailing Address - Country:US
Mailing Address - Phone:505-994-3118
Mailing Address - Fax:
Practice Address - Street 1:5695 KING CENTRE DR STE 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-5745
Practice Address - Country:US
Practice Address - Phone:571-303-1298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119006035225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist