Healthcare Provider Details

I. General information

NPI: 1073422424
Provider Name (Legal Business Name): MS. CLARISSE KUNA MONKAM III
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7958 STREAM WALK WAY
CHESAPEAKE BEACH MD
20732-4665
US

IV. Provider business mailing address

7958 STREAM WALK WAY
CHESAPEAKE BEACH MD
20732-4665
US

V. Phone/Fax

Practice location:
  • Phone: 470-461-5729
  • Fax:
Mailing address:
  • Phone: 470-461-5729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberRN500344226
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: