Provider Demographics
NPI:1336628213
Name:LUCATERO, MONICA RUBI
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:RUBI
Last Name:LUCATERO
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 1:44003 NE 106TH AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-2716
Mailing Address - Country:US
Mailing Address - Phone:360-932-9989
Mailing Address - Fax:
Practice Address - Street 1:44003 NE 106TH AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-2716
Practice Address - Country:US
Practice Address - Phone:360-932-9989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst