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General NPI Number Information
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NPI Number | 1699848473
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Entity Type | Individual
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Provider Name | MARY BETH MONTE OTR
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3200 BIDDLE AVE. 3RD FLOOR
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City | WYANDOTTE
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State | MI
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Zip | 48192-4693
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Country | US
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Telephone | 734-324-3938
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Fax | 734-284-4696
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Provider Business Mailing Address
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Address Line | 15254 GARFIELD AVE
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City | ALLEN PARK
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State | MI
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Zip | 48101-2050
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Country | US
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Telephone | 313-381-0625
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201000277
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License Number State | MI
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