Provider Demographics
NPI:1770649287
Name:MONTE, MELISSA KAY (OTR, CLT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:KAY
Last Name:MONTE
Suffix:
Gender:F
Credentials:OTR, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 BERGAMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-3843
Mailing Address - Country:US
Mailing Address - Phone:608-212-2250
Mailing Address - Fax:
Practice Address - Street 1:990 JANESVILLE ST
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:WI
Practice Address - Zip Code:53575-2954
Practice Address - Country:US
Practice Address - Phone:608-873-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4307-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist