Provider Demographics
NPI:1720005762
Name:TROUT, MONICA DENISE (MS)
Entity Type:Individual
Prefix:MISS
First Name:MONICA
Middle Name:DENISE
Last Name:TROUT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4952 LADY OF THE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3080
Mailing Address - Country:US
Mailing Address - Phone:919-782-6873
Mailing Address - Fax:919-571-4697
Practice Address - Street 1:2406 BLUE RIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6680
Practice Address - Country:US
Practice Address - Phone:919-623-6020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS