Provider Demographics
NPI:1295321511
Name:ABARCA, MONIQUE ASHA NICOLE
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:ASHA NICOLE
Last Name:ABARCA
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 1:10108 SNOW CREST PL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-2532
Mailing Address - Country:US
Mailing Address - Phone:202-230-2300
Mailing Address - Fax:
Practice Address - Street 1:10108 SNOW CREST PL
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-2532
Practice Address - Country:US
Practice Address - Phone:202-230-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8470-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker