Provider Demographics
NPI:1700951191
Name:CLOTHIAUX, MONICA J (MSPT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:J
Last Name:CLOTHIAUX
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:J
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:PO BOX 7087
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-0087
Mailing Address - Country:US
Mailing Address - Phone:703-317-2800
Mailing Address - Fax:703-317-8458
Practice Address - Street 1:5845 RICHMOND HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-1865
Practice Address - Country:US
Practice Address - Phone:703-317-2800
Practice Address - Fax:703-317-8458
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203235225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist