Provider Demographics
NPI:1063571776
Name:ANTONELLI, MONONE MARGARET (OTR)
Entity type:Individual
Prefix:MRS
First Name:MONONE
Middle Name:MARGARET
Last Name:ANTONELLI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:MONONE
Other - Middle Name:MARGARET
Other - Last Name:DURBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:492 COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-8921
Mailing Address - Country:US
Mailing Address - Phone:734-241-6547
Mailing Address - Fax:734-241-1414
Practice Address - Street 1:1048 NORTH MONROE ST.
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162
Practice Address - Country:US
Practice Address - Phone:734-241-1400
Practice Address - Fax:734-241-1414
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001984225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist