Provider Demographics
NPI:1174262786
Name:MONSON, MARISSA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:MONSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 PARK ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH WAYNE
Mailing Address - State:WI
Mailing Address - Zip Code:53587-9601
Mailing Address - Country:US
Mailing Address - Phone:608-482-4795
Mailing Address - Fax:
Practice Address - Street 1:1400 EASTSIDE RD
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-9800
Practice Address - Country:US
Practice Address - Phone:608-348-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist