Provider Demographics
NPI:1336915354
Name:OOTHOUT, MONICA JOSEPHINE
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:JOSEPHINE
Last Name:OOTHOUT
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 1:13900 RUSSELL ST APT 316
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2540
Mailing Address - Country:US
Mailing Address - Phone:913-777-1188
Mailing Address - Fax:
Practice Address - Street 1:13900 RUSSELL ST APT 316
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2540
Practice Address - Country:US
Practice Address - Phone:913-777-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach