Provider Demographics
NPI:1780346239
Name:SAUNDERS, MONICA DENISE
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:DENISE
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:DENISE
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13409 REID CIR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-6522
Mailing Address - Country:US
Mailing Address - Phone:202-779-8059
Mailing Address - Fax:
Practice Address - Street 1:13409 REID CIR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-6522
Practice Address - Country:US
Practice Address - Phone:202-779-8059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS536609139080103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS536609139080Medicaid