Provider Demographics
NPI:1306080858
Name:WASHINGTON, MONICA WILLIAMS
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:WILLIAMS
Last Name:WASHINGTON
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 1:5740 HENDERSON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-1819
Mailing Address - Country:US
Mailing Address - Phone:704-907-0016
Mailing Address - Fax:
Practice Address - Street 1:5740 HENDERSON OAKS DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1819
Practice Address - Country:US
Practice Address - Phone:704-907-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator