Provider Demographics
NPI:1588034482
Name:HARDEN, MONICA WHARTON (DC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:WHARTON
Last Name:HARDEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LORRAINE
Other - Last Name:WHARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1255 VICTORIA HILLS DR N
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-8864
Mailing Address - Country:US
Mailing Address - Phone:812-327-1402
Mailing Address - Fax:321-362-7553
Practice Address - Street 1:5860 RED BUG LAKE RD
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5011
Practice Address - Country:US
Practice Address - Phone:407-790-4745
Practice Address - Fax:407-846-6277
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 11679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor