Provider Demographics
NPI:1912449984
Name:AGUIRRE, MONIQUE L (MA, DRPH(C))
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:L
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:MA, DRPH(C)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 HICKORY STATION CIR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6179
Mailing Address - Country:US
Mailing Address - Phone:770-337-1007
Mailing Address - Fax:470-539-4646
Practice Address - Street 1:1920 HICKORY STATION CIR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6179
Practice Address - Country:US
Practice Address - Phone:770-337-1007
Practice Address - Fax:470-539-4646
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health