Provider Demographics
NPI:1972347581
Name:DELAAT, JULIE MICHELLE (COTA/L)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MICHELLE
Last Name:DELAAT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MICHELLE
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:270 BEDFORD RD N
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-1835
Mailing Address - Country:US
Mailing Address - Phone:269-968-2296
Mailing Address - Fax:
Practice Address - Street 1:9348 W H AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-8587
Practice Address - Country:US
Practice Address - Phone:269-370-2398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202008538224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant