| Doctor Name: | MONA HABIB |
| NPI Number: | 1174876494 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PMHNP-BC |
| License Number: | 4704294838 |
| Business Practice Address: | 5 N Atkinson Dr Suite 304 Ludington, MI - 494312918 |
| Business Phone Number: | 2318453615 |
| Business Fax Number: | 2318453637 |
| Mailing Address: | 100 Michigan St Ne # Mc845, Suite 304 GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495032560 |
| Phone Number: | 6164866790 |
| Fax Number: | 6164866702 |
| NPI Enumeration Date: | 10/24/2012 |
| NPI Last Update Date: | 09/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 4704294838 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |