Provider Demographics
NPI:1073202537
Name:MCLEAN, MONICA GRACE
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:GRACE
Last Name:MCLEAN
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 1:6544 ROSEBROOK LN
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-4347
Mailing Address - Country:US
Mailing Address - Phone:740-251-8718
Mailing Address - Fax:
Practice Address - Street 1:6544 ROSEBROOK LN
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-4347
Practice Address - Country:US
Practice Address - Phone:740-251-8718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health