Provider Demographics
NPI:1144492265
Name:DOTSON, MONICA JEAN (PT)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:JEAN
Last Name:DOTSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6541 N CALLE PADRE FELIPE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-1904
Mailing Address - Country:US
Mailing Address - Phone:520-575-4081
Mailing Address - Fax:
Practice Address - Street 1:6541 N CALLE PADRE FELIPE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-1904
Practice Address - Country:US
Practice Address - Phone:520-575-4081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ782616OtherAHCCCS