Provider Demographics
NPI:1689370272
Name:MONCRIEFFE, SHUANNA TONI (MSCEM, NASM-CNC)
Entity Type:Individual
Prefix:
First Name:SHUANNA
Middle Name:TONI
Last Name:MONCRIEFFE
Suffix:
Gender:F
Credentials:MSCEM, NASM-CNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9812 FALLS RD STE 114-324
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3976
Mailing Address - Country:US
Mailing Address - Phone:240-762-1279
Mailing Address - Fax:
Practice Address - Street 1:12820 RIVER RD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-1139
Practice Address - Country:US
Practice Address - Phone:240-994-2902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1230950801171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD92-1308163OtherINTERNAL REVENUE SERVICE