Individual
MISS LISA JEAN BROUGHTEN MONJEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1900 CENTRACARE CIRCLE #1300, CENTRACARE CLINIC HEALTH PLAZA PEDIATRIC/ADOLESCENT MED, ST CLOUD, MN 56303-5000
(320) 229-3610
(320) 229-3647
Mailing address
1900 CENTRACARE CIRCLE #1300, CENTRACARE CLINIC HEALTH PLAZA PEDIATRIC/ADOLESCENT MED, ST CLOUD, MN 56303-5000
(320) 229-3610
(320) 229-3647
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
102738
MN
225X00000X
Occupational Therapist
Primary
102738
MN
Other
Enumeration date
12/04/2006
Last updated
10/18/2017
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