Provider Demographics
NPI:1932320678
Name:SCHMITT, MONIQUE ELIZABETH (MS,CCC,SLP)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:ELIZABETH
Last Name:SCHMITT
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 1:144 WATERSTON AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-3432
Mailing Address - Country:US
Mailing Address - Phone:864-650-2729
Mailing Address - Fax:
Practice Address - Street 1:801 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-3052
Practice Address - Country:US
Practice Address - Phone:508-586-5977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3822235Z00000X
MA5707235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA0902Medicaid