Healthcare Provider Details

I. General information

NPI: 1417876467
Provider Name (Legal Business Name): JULIA NICOLE CLIMO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 FREMONT ST
MACHIAS ME
04654-1320
US

IV. Provider business mailing address

2106 PANIOLO DR
BOERNE TX
78006-2754
US

V. Phone/Fax

Practice location:
  • Phone: 207-598-7775
  • Fax:
Mailing address:
  • Phone: 832-755-2064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number28315
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT5028
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: