Provider Demographics
NPI:1023508397
Name:DAVIS, MONIQUE (MBA, MS)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MBA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 90951
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20090-0951
Mailing Address - Country:US
Mailing Address - Phone:240-685-8091
Mailing Address - Fax:
Practice Address - Street 1:8700 FRANCESCA DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2850
Practice Address - Country:US
Practice Address - Phone:240-685-8091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-13
Last Update Date:2018-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath