Provider Demographics
NPI:1861622987
Name:HASULUBE, JUSTINE RUTH (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JUSTINE
Middle Name:RUTH
Last Name:HASULUBE
Suffix:
Gender:F
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 1:2410 SUNFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-1547
Mailing Address - Country:US
Mailing Address - Phone:630-844-1584
Mailing Address - Fax:
Practice Address - Street 1:2410 SUNFLOWER CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1547
Practice Address - Country:US
Practice Address - Phone:630-844-1584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.004485225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics