Provider Demographics
NPI:1124389358
Name:MINGA, JAMILA MONIQUE (PHD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:MONIQUE
Last Name:MINGA
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 RESTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-6219
Mailing Address - Country:US
Mailing Address - Phone:919-272-5074
Mailing Address - Fax:
Practice Address - Street 1:108 RESTONWOOD DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-6219
Practice Address - Country:US
Practice Address - Phone:919-272-5074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6770235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist