Provider Demographics
NPI:1528411501
Name:HOWARD, MONIQUE
Entity Type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MONIQUE
Other - Middle Name:
Other - Last Name:BAZILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11416 WARREN BLVD APT 208
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-1045
Mailing Address - Country:US
Mailing Address - Phone:313-695-9839
Mailing Address - Fax:
Practice Address - Street 1:11416 WARREN BLVD APT 208
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-1045
Practice Address - Country:US
Practice Address - Phone:313-695-9839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other