Healthcare Provider Details

I. General information

NPI: 1437751542
Provider Name (Legal Business Name): JOSLYNN MONROIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20452 KINGSTON DR
CLINTON TWP MI
48036-2254
US

IV. Provider business mailing address

20452 KINGSTON DR
CLINTON TWP MI
48036-2254
US

V. Phone/Fax

Practice location:
  • Phone: 586-354-5057
  • Fax:
Mailing address:
  • Phone: 586-354-5057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: