Provider Demographics
NPI:1568177103
Name:WEBB, MONIQUE DENINE
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:DENINE
Last Name:WEBB
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MONIQUE
Other - Middle Name:DENINE
Other - Last Name:CAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:25021 AURORA RD TRLR 312
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146
Mailing Address - Country:US
Mailing Address - Phone:216-253-5486
Mailing Address - Fax:
Practice Address - Street 1:25021 AURORA RD TRLR 312
Practice Address - Street 2:
Practice Address - City:BEDFORD HTS
Practice Address - State:OH
Practice Address - Zip Code:44146
Practice Address - Country:US
Practice Address - Phone:216-253-5486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X
OH374U00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide