Provider Demographics
NPI:1972283026
Name:MCDONALD, MONIQUE YVETTE
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:YVETTE
Last Name:MCDONALD
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 1:14850 W DIXIE HWY APT 26
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1048
Mailing Address - Country:US
Mailing Address - Phone:786-780-3051
Mailing Address - Fax:
Practice Address - Street 1:14850 W DIXIE HWY APT 26
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1048
Practice Address - Country:US
Practice Address - Phone:786-780-3051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician