Provider Demographics
NPI:1437403169
Name:MENDEZ-TIMMONS, MONIQUE NICOLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:NICOLE
Last Name:MENDEZ-TIMMONS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MONIQUE
Other - Middle Name:NICOLE
Other - Last Name:MENDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:817 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-5621
Mailing Address - Country:US
Mailing Address - Phone:954-785-8285
Mailing Address - Fax:954-928-0040
Practice Address - Street 1:817 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-5621
Practice Address - Country:US
Practice Address - Phone:954-785-8285
Practice Address - Fax:954-928-0040
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8592103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical