Provider Demographics
NPI:1578148490
Name:CRISWELL, JULIA TERESA (OTR/L)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:TERESA
Last Name:CRISWELL
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 E 101ST ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-4110
Mailing Address - Country:US
Mailing Address - Phone:216-791-8118
Mailing Address - Fax:
Practice Address - Street 1:1909 E 101ST ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-4110
Practice Address - Country:US
Practice Address - Phone:216-791-8118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
OHOT011379225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist