Doctor Name: | WAYNE MONK |
NPI Number: | 1053443747 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 220 4th Ave Raton, NM - 87740 |
Business Phone Number: | 5754452754 |
Business Fax Number: | 5754452225 |
Mailing Address: | 220 4th Ave, RATON |
State: | NM |
Postal Code: | 87740 |
Phone Number: | 5754452754 |
Fax Number: | 5754452225 |
NPI Enumeration Date: | 03/09/2007 |
NPI Last Update Date: | 08/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |