Provider Demographics
NPI:1659964666
Name:MILLER-HESS, MONICA ANNEMARIE (RBT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:ANNEMARIE
Last Name:MILLER-HESS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 SW 21ST LN
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-7707
Mailing Address - Country:US
Mailing Address - Phone:239-443-7012
Mailing Address - Fax:
Practice Address - Street 1:1210 SE 46TH LN
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-8601
Practice Address - Country:US
Practice Address - Phone:239-268-8707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20-140081106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician