Provider Demographics
NPI:1699848473
Name:MONTE, MARY BETH (OTR)
Entity type:Individual
Prefix:MRS
First Name:MARY BETH
Middle Name:
Last Name:MONTE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15254 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2050
Mailing Address - Country:US
Mailing Address - Phone:313-381-0625
Mailing Address - Fax:
Practice Address - Street 1:3200 BIDDLE AVE.
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-4693
Practice Address - Country:US
Practice Address - Phone:734-324-3938
Practice Address - Fax:734-284-4696
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000277225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist