Provider Demographics
NPI:1699439596
Name:MONAR, LELAH ANN
Entity type:Individual
Prefix:
First Name:LELAH
Middle Name:ANN
Last Name:MONAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 N FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:IN
Mailing Address - Zip Code:47635-8867
Mailing Address - Country:US
Mailing Address - Phone:812-686-3738
Mailing Address - Fax:
Practice Address - Street 1:8005 US HIGHWAY 60 W
Practice Address - Street 2:
Practice Address - City:LEWISPORT
Practice Address - State:KY
Practice Address - Zip Code:42351-7079
Practice Address - Country:US
Practice Address - Phone:270-295-6756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY272730225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist