Provider Demographics
NPI:1336868553
Name:RUSZALA, JULIE JANE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:JANE
Last Name:RUSZALA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:JANE
Other - Last Name:RUSZALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:MA
Mailing Address - Zip Code:01085-9536
Mailing Address - Country:US
Mailing Address - Phone:413-862-0276
Mailing Address - Fax:
Practice Address - Street 1:209 ROOT RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-9801
Practice Address - Country:US
Practice Address - Phone:413-568-3942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14303225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics