Provider Demographics
NPI:1740401686
Name:FOUQUET-TYLER, MONICA S (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:S
Last Name:FOUQUET-TYLER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9229 E 37TH ST N STE 201
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2003
Mailing Address - Country:US
Mailing Address - Phone:166-553-4033
Mailing Address - Fax:316-267-8191
Practice Address - Street 1:4921 E 21ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-1602
Practice Address - Country:US
Practice Address - Phone:316-381-3204
Practice Address - Fax:316-681-0541
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002691235Z00000X
KS2900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist