Provider Demographics
NPI:1740610096
Name:MENART, MARIA ELIZABETH (MS OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ELIZABETH
Last Name:MENART
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 LEONARD ST APT 211
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-2964
Mailing Address - Country:US
Mailing Address - Phone:218-290-1305
Mailing Address - Fax:
Practice Address - Street 1:1915 N 34TH ST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-5575
Practice Address - Country:US
Practice Address - Phone:952-224-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-23
Last Update Date:2013-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5405-26225X00000X
MN104216225X00000X
FL16031225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist