Healthcare Provider Details

I. General information

NPI: 1295499929
Provider Name (Legal Business Name): FELICIA EMMA MONTOUTE RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 10/28/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9151 EST. THOMAS STE. 203
ST. THOMAS VI
00802
US

IV. Provider business mailing address

BOIS D'ORANGE C/O RODNEY BAY P.O. GROS ISLET
GROS ISLET SAINT LUCIA
LC 01- 401
LC

V. Phone/Fax

Practice location:
  • Phone: 340-776-6056
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number084
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: