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General NPI Number Information
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NPI Number | 1326307398
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Entity Type | Individual
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Provider Name | DR. MONICA L PATTILLO
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Gender | Female
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 2205 CORDILLERA WAY
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City | EDWARDS
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State | CO
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Zip | 81632-6290
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Country | US
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Telephone | 970-693-0015
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Fax |
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Provider Business Mailing Address
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Address Line | 7993 MILLSTONE CT
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City | SEVERN
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State | MD
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Zip | 21144-1740
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 205183
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT.0002161
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001870
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License Number State | NY
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