Provider Demographics
NPI:1447528542
Name:MORIN, MONIQUE C
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:C
Last Name:MORIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 S SUGAR RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9690
Mailing Address - Country:US
Mailing Address - Phone:956-383-4454
Mailing Address - Fax:956-383-4979
Practice Address - Street 1:3815 S SUGAR RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9690
Practice Address - Country:US
Practice Address - Phone:956-383-4454
Practice Address - Fax:956-383-4979
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1211383225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist