Provider Demographics
NPI:1932827102
Name:CNOBEL MASSION, MONICA S
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:S
Last Name:CNOBEL MASSION
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 1:6510 OMAHA TRL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-1728
Mailing Address - Country:US
Mailing Address - Phone:850-544-6532
Mailing Address - Fax:
Practice Address - Street 1:6510 OMAHA TRL
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-1728
Practice Address - Country:US
Practice Address - Phone:850-544-6532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22253101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health