Provider Demographics
NPI:1497264386
Name:WILLIAMSON, MONIQUE ESTELLE (MFT)
Entity Type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:ESTELLE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 OXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-5821
Mailing Address - Country:US
Mailing Address - Phone:937-304-5384
Mailing Address - Fax:
Practice Address - Street 1:625 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-5821
Practice Address - Country:US
Practice Address - Phone:937-304-5384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1400028106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty