Healthcare Provider Details

I. General information

NPI: 1417868613
Provider Name (Legal Business Name): MARCIA MONK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6519 VIRGILIAN ST
NEW ORLEANS LA
70126-2646
US

IV. Provider business mailing address

1116 FELICITY ST
NEW ORLEANS LA
70130-4775
US

V. Phone/Fax

Practice location:
  • Phone: 504-301-2964
  • Fax:
Mailing address:
  • Phone: 409-828-1306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10057
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: