Provider Demographics
NPI:1841450129
Name:STRAIT, MONICA DAWN
Entity type:Individual
Prefix:MS
First Name:MONICA
Middle Name:DAWN
Last Name:STRAIT
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 1:340 MAIN ST
Mailing Address - Street 2:DAKOTA HEARING INSTRUMENT INC
Mailing Address - City:LAKE ANDES
Mailing Address - State:SD
Mailing Address - Zip Code:57356
Mailing Address - Country:US
Mailing Address - Phone:605-487-7661
Mailing Address - Fax:605-996-3644
Practice Address - Street 1:340 MAIN ST
Practice Address - Street 2:DAKOTA HEARING INSTRUMENT INC
Practice Address - City:LAKE ANDES
Practice Address - State:SD
Practice Address - Zip Code:57356
Practice Address - Country:US
Practice Address - Phone:605-487-7661
Practice Address - Fax:605-996-3644
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD286237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD9152122Medicaid
SD9150300Medicaid