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NPI Code Detail

MEDICARE: MONIQUE DAVIS

MEDICARE: MONIQUE DAVIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator
3101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1023357886
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONIQUE DAVIS
Provider Business Mailing Address
First Line : PO BOX 50140
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70150-0140
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1538 LOUISIANA AVE
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70115-3553
Country : US
Telephone Number : 504-896-2345
Fax Number : 504-896-2240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2013
Last Update Date : 09/21/2020

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Directions to “ MONIQUE DAVIS ” Practice Location

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