Provider Demographics
NPI:1588431209
Name:MONKS, DAWNETTE MARIE (MSW)
Entity type:Individual
Prefix:
First Name:DAWNETTE
Middle Name:MARIE
Last Name:MONKS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DAWNETTE
Other - Middle Name:MARIE
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1120 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-3911
Mailing Address - Country:US
Mailing Address - Phone:406-541-4673
Mailing Address - Fax:
Practice Address - Street 1:1120 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-3911
Practice Address - Country:US
Practice Address - Phone:406-541-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-662251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical