Provider Demographics
NPI:1487903753
Name:COSHENET, MONICA JEAN (OTR/L)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:JEAN
Last Name:COSHENET
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:JEAN
Other - Last Name:MERHEGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:442 CORDOVA AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1274
Mailing Address - Country:US
Mailing Address - Phone:505-440-5922
Mailing Address - Fax:
Practice Address - Street 1:442 CORDOVA AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1274
Practice Address - Country:US
Practice Address - Phone:505-440-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-02
Last Update Date:2012-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2782225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist