Individual
JULIA NICOLE BORETSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(301) 869-7505
Mailing address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7283
SC
225XP0200X
Pediatric Occupational Therapist
09407
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/08/2020
Last updated
12/02/2024
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