Provider Demographics
NPI:1780106914
Name:HASON, MONIQUE LEATEAR
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:LEATEAR
Last Name:HASON
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 1:43 FERN LN
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-9625
Mailing Address - Country:US
Mailing Address - Phone:609-567-5604
Mailing Address - Fax:609-567-5632
Practice Address - Street 1:43 FERN LN
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-9625
Practice Address - Country:US
Practice Address - Phone:609-567-5604
Practice Address - Fax:609-567-5632
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health