Provider Demographics
NPI:1679366710
Name:KIND, MONICA ANN (LMT)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:ANN
Last Name:KIND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:ANN
Other - Last Name:FARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4155 SASHABAW RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-1951
Mailing Address - Country:US
Mailing Address - Phone:810-964-9764
Mailing Address - Fax:
Practice Address - Street 1:2801 ELIZABETH LAKE RD STE 100
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3281
Practice Address - Country:US
Practice Address - Phone:248-683-6260
Practice Address - Fax:248-683-0256
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501011447225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist