Provider Demographics
NPI:1205237674
Name:DEAN, JAVON MONIQUE
Entity type:Individual
Prefix:
First Name:JAVON
Middle Name:MONIQUE
Last Name:DEAN
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 1:1876 KINNEY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45207-1824
Mailing Address - Country:US
Mailing Address - Phone:513-203-6073
Mailing Address - Fax:
Practice Address - Street 1:1876 KINNEY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45207-1824
Practice Address - Country:US
Practice Address - Phone:513-203-6073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst