Provider Demographics
NPI:1740542026
Name:FLESCH, MONICA M (COTA)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:M
Last Name:FLESCH
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:GREENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53129-1442
Mailing Address - Country:US
Mailing Address - Phone:414-423-1399
Mailing Address - Fax:414-423-1473
Practice Address - Street 1:5700 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:GREENDALE
Practice Address - State:WI
Practice Address - Zip Code:53129-1442
Practice Address - Country:US
Practice Address - Phone:414-423-1399
Practice Address - Fax:414-423-1473
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4907-27224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant