Provider Demographics
NPI:1235770025
Name:MENDES MONSANTO, MORGAN (ND)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:MENDES MONSANTO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:MONSANTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:5302 YACHT HAVEN GRANDE STE S102
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-5004
Mailing Address - Country:US
Mailing Address - Phone:760-651-6121
Mailing Address - Fax:
Practice Address - Street 1:5302 YACHT HAVEN GRANDE STE S102
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-5004
Practice Address - Country:US
Practice Address - Phone:340-227-1299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22-1722175F00000X
CAND1109175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath