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NPI Code Detail

MEDICARE: JULISSA LOYOLA OT

MEDICARE: JULISSA LOYOLA OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist107932MN
2225X00000XOccupational Therapist2214ND
3225X00000XOccupational Therapist112724TX

General Provider Information

NPI Number : 1457362535
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULISSA LOYOLA OT
Provider Business Mailing Address
First Line : 3010 CENTRAL CT
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-3502
Country : US
Telephone Number : 908-206-2230
Fax Number : 908-206-2237
Provider Business Practice Location Address
First Line : 3010 CENTRAL CT
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-3502
Country : US
Telephone Number : 973-322-7500
Fax Number : 973-322-7543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 03/12/2026

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Directions to “ JULISSA LOYOLA OT” Practice Location

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