Provider Demographics
NPI:1437637550
Name:LEMIRE, MONIQUE MICHAELA
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:MICHAELA
Last Name:LEMIRE
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 1:3837 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-7723
Mailing Address - Country:US
Mailing Address - Phone:916-693-3504
Mailing Address - Fax:
Practice Address - Street 1:3837 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-7723
Practice Address - Country:US
Practice Address - Phone:916-693-3504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician