MEDICARE: CHRISTINE MONTESI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1023454659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE MONTESI

Provider Business Mailing Address
First Line	:	2233 DEERFIELD DR
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29715-6941
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 SPRINGFIELD PKWY
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29715-8403
Country	:	US
Telephone Number	:	803-548-8209
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2013
Last Update Date	:	05/22/2013

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Directions to “ CHRISTINE MONTESI ” Practice Location

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