Provider Demographics
NPI:1174744650
Name:CROTEAU, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:CROTEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 W 200 N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ST. GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-4505
Mailing Address - Country:US
Mailing Address - Phone:435-634-5600
Mailing Address - Fax:435-986-8700
Practice Address - Street 1:310 SOUTH 100 EAST
Practice Address - Street 2:SUITE 11
Practice Address - City:KANAB
Practice Address - State:UT
Practice Address - Zip Code:84741
Practice Address - Country:US
Practice Address - Phone:435-644-4520
Practice Address - Fax:435-986-8700
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTCROTEMOtherSBHC STAFF CODE