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General NPI Number Information
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NPI Number | 1093415879
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Entity Type | Individual
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Provider Name | MONICA RENEE' HUSEMAN CRC
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Gender | Female
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Dates
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Enumeration Date | 03/09/2023
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 19 CYPRESS KNEE DR
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City | CABOT
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State | AR
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Zip | 72023-8195
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Country | US
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Telephone | 843-826-0558
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Fax |
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Provider Business Mailing Address
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Address Line | 19 CYPRESS KNEE DR
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City | CABOT
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State | AR
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Zip | 72023-8195
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Country | US
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Telephone | 843-826-0558
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176P00000X
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Taxonomy Name | Funeral Director
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License Number | 21682
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.021828
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License Number State | IL
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