Provider Demographics
NPI:1407453103
Name:MOHNEY, ANITA (PTA)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:MOHNEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 CROSSPOINTE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-0918
Mailing Address - Country:US
Mailing Address - Phone:239-231-1415
Mailing Address - Fax:
Practice Address - Street 1:1020 CROSSPOINTE DR STE 1
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-0918
Practice Address - Country:US
Practice Address - Phone:239-231-1415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL378675225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant