Provider Demographics
NPI:1740410794
Name:BARBER, MONIQUE LOUISE
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:LOUISE
Last Name:BARBER
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 1:20926 GRESHAM ST
Mailing Address - Street 2:UNIT 10
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-1849
Mailing Address - Country:US
Mailing Address - Phone:818-326-4437
Mailing Address - Fax:
Practice Address - Street 1:20926 GRESHAM ST
Practice Address - Street 2:UNIT 10
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-1849
Practice Address - Country:US
Practice Address - Phone:818-326-4437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor