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General NPI Number Information
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NPI Number | 1952604662
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Entity Type | Individual
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Provider Name | MONIQUE MAYO D.C./M.T.
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Gender | Female
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Dates
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Enumeration Date | 12/20/2010
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 104 E US HIGHWAY 80 STE 170
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City | FORNEY
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State | TX
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Zip | 75126-8615
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Country | US
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Telephone | 972-357-7050
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Fax | 800-249-4581
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Provider Business Mailing Address
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Address Line | 104 E US HIGHWAY 80 STE 170
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City | FORNEY
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State | TX
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Zip | 75126-8615
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Country | US
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Telephone | 972-357-7050
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Fax | 800-249-4581
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 033885
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 14468
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License Number State | TX
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