Provider Demographics
NPI:1215023205
Name:WEBER, MONICA ROSE
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:ROSE
Last Name:WEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MONICA
Other - Middle Name:ROSE
Other - Last Name:OBERSTAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5220 BOARDWALK DR UNIT E24
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-7324
Mailing Address - Country:US
Mailing Address - Phone:224-688-1534
Mailing Address - Fax:
Practice Address - Street 1:5220 BOARDWALK DR UNIT E24
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-7324
Practice Address - Country:US
Practice Address - Phone:224-688-1534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist