MEDICARE: MONIKA KRISIUKENAITE

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	102X00000X	Poetry Therapist

General Provider Information

NPI Number	:	1770311516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIKA KRISIUKENAITE

Provider Business Mailing Address
First Line	:	1110 E DORAN ST APT D
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-3427
Country	:	US
Telephone Number	:	424-394-4923
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 E DORAN ST APT D
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-3427
Country	:	US
Telephone Number	:	424-394-4923
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2024
Last Update Date	:	07/23/2024

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Directions to “ MONIKA KRISIUKENAITE ” Practice Location

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