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General NPI Number Information
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NPI Number | 1720936651
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Entity Type | Individual
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Provider Name | MONIQUE D MOODY CPT, CMA,DSP
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Gender | Female
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 7780 N 57TH LN
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City | GLENDALE
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State | AZ
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Zip | 85301-7872
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Country | US
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Telephone | 602-456-6138
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Fax |
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Provider Business Mailing Address
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Address Line | 7428 W CAVALIER DR
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City | GLENDALE
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State | AZ
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Zip | 85303-0021
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Country | US
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Telephone | 602-793-9251
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number | 2025B09366
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 2025B09366
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | INST3437836425
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License Number State | MI
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