Healthcare Provider Details

I. General information

NPI: 1477912244
Provider Name (Legal Business Name): MONICA BELTRAMI O.T.R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2016
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 REED BLVD
MILL VALLEY CA
94941-2306
US

IV. Provider business mailing address

39 REED BLVD
MILL VALLEY CA
94941-2306
US

V. Phone/Fax

Practice location:
  • Phone: 540-996-7645
  • Fax:
Mailing address:
  • Phone: 540-996-7645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number3657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: