Provider Demographics
NPI:1033457064
Name:MONUTEAUX, HEIDI MARIE (MA, LMHCA)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:MARIE
Last Name:MONUTEAUX
Suffix:
Gender:F
Credentials:MA, LMHCA
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 574
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-0574
Mailing Address - Country:US
Mailing Address - Phone:206-304-3345
Mailing Address - Fax:
Practice Address - Street 1:10803 SE KENT KANGLEY RD
Practice Address - Street 2:SUITE 207
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7194
Practice Address - Country:US
Practice Address - Phone:206-304-3345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60311508101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional