Provider Demographics
NPI:1922354026
Name:PRINCE, MONIQUE MARIE (BEHAVIOR ANALYST)
Entity type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:MARIE
Last Name:PRINCE
Suffix:
Gender:F
Credentials:BEHAVIOR ANALYST
Other - Prefix:MRS
Other - First Name:MONIQUE
Other - Middle Name:MARIE
Other - Last Name:PRINCE-SPEIGHTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1706 KENTUCKY DERBY DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78417-3122
Mailing Address - Country:US
Mailing Address - Phone:313-746-3008
Mailing Address - Fax:
Practice Address - Street 1:7001 YORKTOWN BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-5869
Practice Address - Country:US
Practice Address - Phone:361-792-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1554103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst