Provider Demographics
NPI:1184055717
Name:MONETTE, ANNE
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:MONETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360A LONE PINE LN
Mailing Address - Street 2:
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-4831
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 CHERRY AVE W
Practice Address - Street 2:
Practice Address - City:PLUM CITY
Practice Address - State:WI
Practice Address - Zip Code:54761-9781
Practice Address - Country:US
Practice Address - Phone:715-647-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-08
Last Update Date:2013-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4969-27224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant