Mona Jean Allen, OTR/L
Individual provider Active NPI Occupational Therapist · Appleton, WI
NPI 1154729630 · NPPES record last updated Dec 15, 2014
Key facts
- NPI
- 1154729630
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 5274-26 (WI)
- Practice address
- 1650 Tri Park Way Ste a
Appleton, WI 54914-1698 - Phone
- (920) 830-6697
- Fax
- (920) 830-6707
- NPI assigned
- Dec 15, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101981 | MN | MD | Occupational Therapist |
| 5274-26 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blankenheim Services, LLC | Occupational Therapist | Past | Accepting new patients |
| Blankenheim Occupational Therapy | Occupational Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5274-26 | WI | Yes |
| Occupational Therapist | 225X00000X | 101981 | MN |
Addresses
Primary practice location
1650 Tri Park Way Ste a
Appleton, WI 54914-1698
Mailing address
1650 Tri Park Way Ste a
Appleton, WI 54914-1698
Phone (920) 830-6697
Other providers in Appleton, WI
- Avery Allard
- Allcare Dental & Dentures of Wi PC
- Trever Jaymes Allcock
- Catherine A Allen
- Eric Allen
- Allergy and Asthma Associates, SC
- John N Allhiser
- Kristina Rae Almanza
- John E Almquist
- Alovia Care
All providers in Appleton, WI · Occupational Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.