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NPI Code Detail

MEDICARE: MIRIAM ANN MONAHAN

MEDICARE: MIRIAM ANN MONAHAN
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
1225XR0403XDriving and Community Mobility Occupational Therapist0720000115VT

General Provider Information

NPI Number : 1396888293
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRIAM ANN MONAHAN
Provider Business Mailing Address
First Line : 164 CEMETERY RD
Second Line :
City : RICHMOND
State : VT
Zip : 05477-9442
Country : US
Telephone Number : 802-434-7630
Fax Number :
Provider Business Practice Location Address
First Line : 158 HURRICANE LN
Second Line :
City : WILLISTON
State : VT
Zip : 05495-2072
Country : US
Telephone Number : 802-847-3140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2007
Last Update Date : 07/08/2007

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