Provider Demographics
NPI:1881356863
Name:BHAKTA, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:BHAKTA
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 1:19701 ANN RICHARDS AVE
Mailing Address - Street 2:
Mailing Address - City:MANOR
Mailing Address - State:TX
Mailing Address - Zip Code:78653
Mailing Address - Country:US
Mailing Address - Phone:740-707-0208
Mailing Address - Fax:
Practice Address - Street 1:19701 ANN RICHARDS AVE
Practice Address - Street 2:
Practice Address - City:MANOR
Practice Address - State:TX
Practice Address - Zip Code:78653
Practice Address - Country:US
Practice Address - Phone:740-707-0208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist