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General NPI Number Information
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NPI Number | 1235127218
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Entity Type | Individual
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Provider Name | MONIQUE J. TREMAINE PHD, MSCP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 23 GRAND AVE
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City | ATLANTIC HIGHLANDS
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State | NJ
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Zip | 07716-1347
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Country | US
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Telephone | 858-204-1717
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Fax | 973-799-9283
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Provider Business Mailing Address
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Address Line | 23 GRAND AVE
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City | ATLANTIC HIGHLANDS
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State | NJ
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Zip | 07716-1347
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Country | US
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Telephone | 858-204-1717
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Fax | 973-799-9283
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35SI00438500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 051-A243
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License Number State | NJ
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