| Montera Health Wisconsin Llc | |
|
2800 E Enterprise Ave Ste 333 Appleton WI 54913-7889 | |
| (865) 680-1516 | |
| Not Available |
| Full Name | Montera Health Wisconsin Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2800 E Enterprise Ave Ste 333, Appleton, Wisconsin |
| Authorized Official Name and Position | Qingqing Mao (ADMIN) |
| Authorized Official Contact | 4158051725 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Montera Health Wisconsin Llc 2800 E Enterprise Ave Ste 333 Appleton WI 54913-7889 Ph: (865) 680-1516 | Montera Health Wisconsin Llc 2800 E Enterprise Ave Ste 333 Appleton WI 54913-7889 Ph: (865) 680-1516 |
| NPI Number | 1285380915 |
|---|---|
| Provider Enumeration Date | 02/22/2022 |
| Last Update Date | 01/31/2024 |
| Certification Date | 01/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285380915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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