MEDICARE: MONIQUE STANFIELD PSY.D, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1447016662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONIQUE STANFIELD PSY.D, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 34120
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89533-4120
Country	:	US
Telephone Number	:	775-843-9767
Fax Number	:	775-747-5005

Provider Business Practice Location Address
First Line	:	1881 S ARLINGTON AVE
Second Line	:	SUITE 201
City	:	RENO
State	:	NV
Zip	:	89509
Country	:	US
Telephone Number	:	775-843-9767
Fax Number	:	775-747-5005

Authorized Official
Title or Position	:	OWNER
Name	:	MONIQUE STANFIELD
Credential	:	PSY.D
Telephone Number	:	775-843-6126

Provider Enumeration Date	:	02/26/2024
Last Update Date	:	02/26/2024

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