Provider Demographics
NPI:1821182866
Name:MALCEIN, MONICA S (PHD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:S
Last Name:MALCEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:MALCEIN TOROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:88 MDG/SGHJ
Mailing Address - Street 2:4881 SUGAR MAPLE DR
Mailing Address - City:WRIGHT-PATTERSON AFB
Mailing Address - State:OH
Mailing Address - Zip Code:45433-9222
Mailing Address - Country:US
Mailing Address - Phone:937-938-2768
Mailing Address - Fax:
Practice Address - Street 1:2510 5TH ST BLDG 840
Practice Address - Street 2:
Practice Address - City:WRIGHT PATTERSON AFB
Practice Address - State:OH
Practice Address - Zip Code:45433-7951
Practice Address - Country:US
Practice Address - Phone:937-938-2768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2717103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical