Individual
MRS. MONICA JEAN GOODREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT, CHT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201004379
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34-26
DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES OT
WI
Enumeration date
04/25/2018
Last updated
04/25/2018
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