Provider Demographics
NPI:1518051549
Name:PROCTOR, MONICA HALLER (MD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:HALLER
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12111 CHIPPEWA RD
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-2127
Mailing Address - Country:US
Mailing Address - Phone:440-546-7165
Mailing Address - Fax:440-546-2753
Practice Address - Street 1:10000 BRECKSVILLE RD
Practice Address - Street 2:(B)51A
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-3204
Practice Address - Country:US
Practice Address - Phone:440-526-3030
Practice Address - Fax:440-546-2753
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-07-0554-P2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry