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General NPI Number Information
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NPI Number | 1316125636
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Entity Type | Individual
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Provider Name | JULIE HASTINGS DESHONG OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 1700 REISTERSTOWN RD SUITE 232
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City | PIKESVILLE
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State | MD
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Zip | 21208-1416
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Country | US
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Telephone | 410-571-6411
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Fax | 410-571-6415
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Provider Business Mailing Address
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Address Line | PO BOX 891
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City | LAUREL
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State | MD
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Zip | 20725-0891
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Country | US
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Telephone | 410-571-6411
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Fax | 410-571-6415
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 03068
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License Number State | MD
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