Provider Demographics
NPI:1952805590
Name:WITTRUP, JULIANNA (OTR/L)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:
Last Name:WITTRUP
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:J
Other - Last Name:WITTRUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:11830 N 75TH ST UNIT 384
Mailing Address - Street 2:
Mailing Address - City:HYGIENE
Mailing Address - State:CO
Mailing Address - Zip Code:80533-7417
Mailing Address - Country:US
Mailing Address - Phone:808-359-3374
Mailing Address - Fax:
Practice Address - Street 1:1000 GREG KRUSCHEK AVENUE
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762-0966
Practice Address - Country:US
Practice Address - Phone:907-443-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT.60913624225X00000X
CAOT.16182225X00000X
COOT.0004576225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist