Provider Demographics
NPI:1487211454
Name:MONI, YACIHUILCA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:YACIHUILCA
Middle Name:
Last Name:MONI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-3316
Mailing Address - Country:US
Mailing Address - Phone:860-655-1349
Mailing Address - Fax:
Practice Address - Street 1:16 8TH ST
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-3316
Practice Address - Country:US
Practice Address - Phone:860-655-1349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist