MEDICARE: GRETCHEN LILY MONTIE

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	225XP0200X	Pediatric Occupational Therapist

General Provider Information

NPI Number	:	1033060793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRETCHEN LILY MONTIE

Provider Business Mailing Address
First Line	:	41 OCEAN RIDGE DR
Second Line	:
City	:	CHARLESTOWN
State	:	RI
Zip	:	02813-1838
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	66 MAIN ST
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-3651
Country	:	US
Telephone Number	:	401-360-6362
Fax Number	:

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

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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Directions to “ GRETCHEN LILY MONTIE ” Practice Location

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