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NPI Code Detail

MEDICARE: SHEA MONIQUE POYTHRESS

MEDICARE: SHEA MONIQUE POYTHRESS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1699627190
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEA MONIQUE POYTHRESS
Provider Business Mailing Address
First Line : 6460 CENTERVILLE BUSINESS PKWY
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-2633
Country : US
Telephone Number : 937-723-6453
Fax Number :
Provider Business Practice Location Address
First Line : 6460 CENTERVILLE BUSINESS PKWY
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-2633
Country : US
Telephone Number : 937-723-6453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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Directions to “ SHEA MONIQUE POYTHRESS ” Practice Location

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