Provider Demographics
NPI:1629766126
Name:ROSSELL, MONIQUE IRENE
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:IRENE
Last Name:ROSSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 SADDLE RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-9111
Mailing Address - Country:US
Mailing Address - Phone:559-798-4406
Mailing Address - Fax:
Practice Address - Street 1:5505 CHEVIOT RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-7003
Practice Address - Country:US
Practice Address - Phone:513-740-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician