Provider Demographics
NPI:1831799725
Name:DANIEL, MONIQUE ALICIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:ALICIA
Last Name:DANIEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 PUMPKINSEED CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4268
Mailing Address - Country:US
Mailing Address - Phone:301-938-4917
Mailing Address - Fax:
Practice Address - Street 1:40 DRURY DR
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4220
Practice Address - Country:US
Practice Address - Phone:301-392-9106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist