Provider Demographics
NPI:1942693247
Name:COLOTARIO PICKETT, MONICA (PTA)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:COLOTARIO PICKETT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:E
Other - Last Name:COLOTARIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 COBBLESTONE CURV
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36067-4520
Mailing Address - Country:US
Mailing Address - Phone:334-717-3788
Mailing Address - Fax:
Practice Address - Street 1:815 COBBLESTONE CURV
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-4520
Practice Address - Country:US
Practice Address - Phone:334-717-3788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTA7120225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant