Provider Demographics
NPI:1073529830
Name:PLUMB, MONIKA A (PHD)
Entity Type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:A
Last Name:PLUMB
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-2538
Mailing Address - Country:US
Mailing Address - Phone:618-529-2273
Mailing Address - Fax:618-549-8321
Practice Address - Street 1:800 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-2538
Practice Address - Country:US
Practice Address - Phone:618-529-2273
Practice Address - Fax:618-549-8321
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional