Provider Demographics
NPI:1962469692
Name:DABNEY, MONICA (LAC)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:DABNEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 DOESKIN DRIVE
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-8644
Mailing Address - Country:US
Mailing Address - Phone:305-967-0626
Mailing Address - Fax:888-965-9917
Practice Address - Street 1:3920 DOESKIN DRIVE
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-8644
Practice Address - Country:US
Practice Address - Phone:919-762-0729
Practice Address - Fax:888-965-9917
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1416171100000X
NC2005LAC171100000X, 171100000X
NCLAC2005171100000X
AP1416171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102428900Medicaid