Healthcare Provider Details

I. General information

NPI: 1366372864
Provider Name (Legal Business Name): MONIQUE ISABEL WAMBST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONIQUE ISABEL LMHC

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 VILLAGE BLVD APT 1107
WEST PALM BEACH FL
33409-2851
US

IV. Provider business mailing address

8321 SW 27TH ST
MIAMI FL
33155-2406
US

V. Phone/Fax

Practice location:
  • Phone: 305-898-7738
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMH27344
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: