Provider Demographics
NPI:1992449516
Name:DEETS, JULIA J (ATR-BC, LCPAT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:J
Last Name:DEETS
Suffix:
Gender:F
Credentials:ATR-BC, LCPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4969 COLUMBIA RD APT 101
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-5500
Mailing Address - Country:US
Mailing Address - Phone:443-853-0118
Mailing Address - Fax:
Practice Address - Street 1:4969 COLUMBIA RD APT 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-5500
Practice Address - Country:US
Practice Address - Phone:443-853-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDATC093221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist