Provider Demographics
NPI:1427118322
Name:BURKHOLDER, JULIE ELIZABETH (COTA)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ELIZABETH
Last Name:BURKHOLDER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 10TH ST SW
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-2132
Mailing Address - Country:US
Mailing Address - Phone:330-753-3604
Mailing Address - Fax:
Practice Address - Street 1:1533 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1711
Practice Address - Country:US
Practice Address - Phone:330-688-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.02968224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant