Provider Demographics
NPI:1649618307
Name:MONSON, CHRISTIAN H (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:H
Last Name:MONSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W 300 N
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-1763
Mailing Address - Country:US
Mailing Address - Phone:208-320-7525
Mailing Address - Fax:
Practice Address - Street 1:722 W 100 S
Practice Address - Street 2:SUITE 1
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-3739
Practice Address - Country:US
Practice Address - Phone:208-320-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSE-202721103TC0700X
UT8800479-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical