Provider Demographics
NPI:1407464498
Name:MONYPENNY, JUNIPER MEADOWLARK (MA LCAT ATR-BC)
Entity Type:Individual
Prefix:MS
First Name:JUNIPER
Middle Name:MEADOWLARK
Last Name:MONYPENNY
Suffix:
Gender:F
Credentials:MA LCAT ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 HALSEY ST APT 4L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-6292
Mailing Address - Country:US
Mailing Address - Phone:929-404-1223
Mailing Address - Fax:
Practice Address - Street 1:1235 HALSEY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-6231
Practice Address - Country:US
Practice Address - Phone:929-404-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17-093221700000X
NY002387221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist