Provider Demographics
NPI:1043571078
Name:DOVE, MONIKA K (MA)
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:K
Last Name:DOVE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85661
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29073-0032
Mailing Address - Country:US
Mailing Address - Phone:803-755-0681
Mailing Address - Fax:803-755-0677
Practice Address - Street 1:218B E MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3578
Practice Address - Country:US
Practice Address - Phone:803-755-0681
Practice Address - Fax:803-755-0677
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health