Provider Demographics
NPI:1962903997
Name:MONNICHMOBLEY, DEBBIE (COTA)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:MONNICHMOBLEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4130 GREAT FOREST CT
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2489
Mailing Address - Country:US
Mailing Address - Phone:281-810-7111
Mailing Address - Fax:
Practice Address - Street 1:4130 GREAT FOREST CT
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2489
Practice Address - Country:US
Practice Address - Phone:832-588-0829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-25
Last Update Date:2018-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209458224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty