MEDICARE: ANNE MONETTE

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	224Z00000X	Occupational Therapy Assistant	4969-27	WI

General Provider Information

NPI Number	:	1184055717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNE MONETTE

Provider Business Mailing Address
First Line	:	1360A LONE PINE LN
Second Line	:
City	:	AMERY
State	:	WI
Zip	:	54001-4831
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 CHERRY AVE W
Second Line	:
City	:	PLUM CITY
State	:	WI
Zip	:	54761-9781
Country	:	US
Telephone Number	:	715-647-2401
Fax Number	:

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

Provider Enumeration Date	:	12/08/2013
Last Update Date	:	12/08/2013

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Directions to “ ANNE MONETTE ” Practice Location

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