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General NPI Number Information
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NPI Number | 1548989924
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Entity Type | Organization
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Legal Business Name | MONUMENTAL THERAPY GROUP PLLC
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Dates
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Enumeration Date | 08/26/2022
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Last Update Date | 08/26/2022
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Provider Practice Location Address
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Address Line | 755 HIGHWAY 105 UNIT 2C
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City | PALMER LAKE
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State | CO
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Zip | 80133-9040
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Country | US
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Telephone | 719-357-6175
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 LAKE PLAZA DR STE 125
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3581
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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 | BILLING DIRECTOR
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Name | DANI CRAWFORD
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Credential |
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Telephone | 970-573-7780
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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 |
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License Number State |
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