MEDICARE: MONICA ANNE DEVINE-HALEY LCAT

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	221700000X	Art Therapist	001242	NY

General Provider Information

NPI Number	:	1871000687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA ANNE DEVINE-HALEY LCAT

Provider Business Mailing Address
First Line	:	24 GARDINER PARK
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14607-1812
Country	:	US
Telephone Number	:	585-469-4975
Fax Number	:

Provider Business Practice Location Address
First Line	:	2376 MONROE AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3032
Country	:	US
Telephone Number	:	585-430-9877
Fax Number	:	585-200-3215

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

Provider Enumeration Date	:	01/02/2018
Last Update Date	:	02/15/2021

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