Provider Demographics
NPI:1366183477
Name:DAWSON, MONIQUE SHONTELL
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:SHONTELL
Last Name:DAWSON
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 1:69 ROBERT SMALLS PKWY STE 3F
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-4275
Mailing Address - Country:US
Mailing Address - Phone:843-379-3321
Mailing Address - Fax:866-502-3509
Practice Address - Street 1:69 ROBERT SMALLS PKWY STE 3F
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-4275
Practice Address - Country:US
Practice Address - Phone:843-379-3321
Practice Address - Fax:866-502-3509
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator