Provider Demographics
NPI:1760697254
Name:FEAGLER, MONICA KATHERINE (NCC)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:KATHERINE
Last Name:FEAGLER
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746
Mailing Address - Street 2:
Mailing Address - City:MINTURN
Mailing Address - State:CO
Mailing Address - Zip Code:81645-0746
Mailing Address - Country:US
Mailing Address - Phone:970-827-5497
Mailing Address - Fax:970-827-5496
Practice Address - Street 1:320 BEARD CREEK ROAD
Practice Address - Street 2:
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632
Practice Address - Country:US
Practice Address - Phone:970-569-7520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0315968101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool