Provider Demographics
NPI:1265207245
Name:ASSELIN, MONIQUE FAITH
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:FAITH
Last Name:ASSELIN
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 1:61 OXFORD ST APT B
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-2915
Mailing Address - Country:US
Mailing Address - Phone:860-916-1532
Mailing Address - Fax:
Practice Address - Street 1:255 BANK ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2236
Practice Address - Country:US
Practice Address - Phone:860-929-1715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor