Provider Demographics
NPI:1427344076
Name:PERRIER, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:PERRIER
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:PO BOX 3633
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83816-2522
Mailing Address - Country:US
Mailing Address - Phone:208-651-0598
Mailing Address - Fax:
Practice Address - Street 1:1034 N 3RD ST
Practice Address - Street 2:SUITE 1
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-3145
Practice Address - Country:US
Practice Address - Phone:208-651-0598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA6019990225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist