Individual
LYDIA JO MONFORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,OTR/L
Contact information
Practice address
1000 N 92ND ST, MILWAUKEE, WI 53226-3533
(414) 259-1414
(414) 259-0575
Mailing address
N63W23347 MAIN ST APT 301, SUSSEX, WI 53089-3824
(920) 660-5182
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
711926
WI
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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