Doctor Name: | MONICA HUBBARD |
NPI Number: | 1275982829 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2936 |
Business Practice Address: | 1136 Main St Fortuna, CA - 955402102 |
Business Phone Number: | 2064095393 |
Business Fax Number: | |
Mailing Address: | 1136 Main St, FORTUNA |
State: | CA |
Postal Code: | 955402102 |
Phone Number: | 2064095393 |
Fax Number: | |
NPI Enumeration Date: | 06/05/2016 |
NPI Last Update Date: | 06/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2936 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |