Healthcare Provider Details

I. General information

NPI: 1235865601
Provider Name (Legal Business Name): UNKEE MONKEE ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2022
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 TIMBER RIDGE TRL
LORENA TX
76655-3035
US

IV. Provider business mailing address

18 TIMBER RIDGE TRL
LORENA TX
76655-3035
US

V. Phone/Fax

Practice location:
  • Phone: 315-569-7838
  • Fax:
Mailing address:
  • Phone: 315-569-7838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JAMES M HORN
Title or Position: MEMBER
Credential: OTR/L
Phone: 315-569-7838