Provider Demographics
NPI:1407267719
Name:MONNETT, VICTORIA SUE
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:SUE
Last Name:MONNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:SUE
Other - Last Name:MONNETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:14 STARLINE WAY
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02921-3409
Mailing Address - Country:US
Mailing Address - Phone:401-943-7675
Mailing Address - Fax:
Practice Address - Street 1:14 STARLINE WAY
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02921-3409
Practice Address - Country:US
Practice Address - Phone:401-943-7675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)