Doctor Name: | MONIQUE EASTIS |
NPI Number: | 1063800860 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SWP-LCSW-LIC-8987 |
Business Practice Address: | 600 Dewey Blvd Butte, MT - 597013214 |
Business Phone Number: | 8588295782 |
Business Fax Number: | |
Mailing Address: | 825 Pennsylvania Ave, DEER LODGE |
State: | MT |
Postal Code: | 597221741 |
Phone Number: | 8588295782 |
Fax Number: | |
NPI Enumeration Date: | 12/31/2014 |
NPI Last Update Date: | 12/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | SWP-LCSW-LIC-8987 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |