Provider Demographics
NPI:1437735990
Name:HOGANS-WHITE, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:HOGANS-WHITE
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 1:20274 CENTRAL AVE W
Mailing Address - Street 2:
Mailing Address - City:BLOUNTSTOWN
Mailing Address - State:FL
Mailing Address - Zip Code:32424-1957
Mailing Address - Country:US
Mailing Address - Phone:850-447-4546
Mailing Address - Fax:850-237-1223
Practice Address - Street 1:20274 CENTRAL AVE W
Practice Address - Street 2:
Practice Address - City:BLOUNTSTOWN
Practice Address - State:FL
Practice Address - Zip Code:32424-1957
Practice Address - Country:US
Practice Address - Phone:850-674-8888
Practice Address - Fax:850-237-1223
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health