Individual
JULIA M FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
601 GATEWAY BLVD N, CHESTERTON, IN 46304-9658
(219) 921-1444
Mailing address
752 COFFEE CREEK RD, CHESTERTON, IN 46304-1406
(219) 928-6033
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31007083A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4420122543
DRIVERS LICENSE
IN
Enumeration date
01/30/2020
Last updated
12/14/2022
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