Healthcare Provider Details

I. General information

NPI: 1932428638
Provider Name (Legal Business Name): MONICA LEEANN MOUER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2010
Last Update Date: 05/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17301 STATESVILLE RD
CORNELIUS NC
28031-9353
US

IV. Provider business mailing address

15372 MICHAEL ANDREW RD
HUNTERSVILLE NC
28078-6186
US

V. Phone/Fax

Practice location:
  • Phone: 704-892-8005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number7338
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: