Provider Demographics
NPI:1790982767
Name:CLEMENT, MONICA LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:LOUISE
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LOUSIE
Other - Last Name:JEFFERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1236 MAGNOLIA PL
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7017
Mailing Address - Country:US
Mailing Address - Phone:614-327-8720
Mailing Address - Fax:
Practice Address - Street 1:385 TREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1023
Practice Address - Country:US
Practice Address - Phone:973-676-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017146103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist