Healthcare Provider Details

I. General information

NPI: 1457089492
Provider Name (Legal Business Name): JULIA KOWAL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIA KOWAL MORRISON OTR/L

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 BENTON LN
GLASTONBURY CT
06033-2309
US

IV. Provider business mailing address

82 BENTON LN
GLASTONBURY CT
06033-2309
US

V. Phone/Fax

Practice location:
  • Phone: 860-256-9768
  • Fax:
Mailing address:
  • Phone: 860-256-9768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number005745
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7481
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5745
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: