Provider Demographics
NPI:1124451919
Name:MONIZ, BETHANY (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:
Last Name:MONIZ
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:
Other - Last Name:SKLARSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42 BROWNELL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE COMPTON
Mailing Address - State:RI
Mailing Address - Zip Code:02837-1501
Mailing Address - Country:US
Mailing Address - Phone:401-742-9745
Mailing Address - Fax:
Practice Address - Street 1:68 DEAN ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2713
Practice Address - Country:US
Practice Address - Phone:508-824-1467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA4317224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No101Y00000XBehavioral Health & Social Service ProvidersCounselor