Provider Demographics
NPI:1629554969
Name:TILAKAMONKUL, NATAYA
Entity Type:Individual
Prefix:
First Name:NATAYA
Middle Name:
Last Name:TILAKAMONKUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 YUCCA CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2435
Mailing Address - Country:US
Mailing Address - Phone:951-514-6097
Mailing Address - Fax:
Practice Address - Street 1:1736 YUCCA CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2435
Practice Address - Country:US
Practice Address - Phone:951-514-6097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator