Provider Demographics
NPI:1174901763
Name:MONBLEAU, JANIELLE L (ATC, RN)
Entity type:Individual
Prefix:MRS
First Name:JANIELLE
Middle Name:L
Last Name:MONBLEAU
Suffix:
Gender:F
Credentials:ATC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ARLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-4013
Mailing Address - Country:US
Mailing Address - Phone:978-710-7724
Mailing Address - Fax:
Practice Address - Street 1:204 ARLINGTON ST
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-4013
Practice Address - Country:US
Practice Address - Phone:978-710-7724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1932052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer