Provider Demographics
NPI:1497950190
Name:NUGENT, MONICA LYNN (MS, OTRL)
Entity Type:Individual
Prefix:MISS
First Name:MONICA
Middle Name:LYNN
Last Name:NUGENT
Suffix:
Gender:F
Credentials:MS, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 VILLANOVA AVE
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-2141
Mailing Address - Country:US
Mailing Address - Phone:484-680-2500
Mailing Address - Fax:
Practice Address - Street 1:455 S GULPH RD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3114
Practice Address - Country:US
Practice Address - Phone:610-992-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008455225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics