Provider Demographics
NPI:1053764902
Name:STUBBS, MONIQUE
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:STUBBS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 N TAMPA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-4743
Mailing Address - Country:US
Mailing Address - Phone:813-872-6250
Mailing Address - Fax:813-872-6078
Practice Address - Street 1:3809 N TAMPA ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-4743
Practice Address - Country:US
Practice Address - Phone:813-872-6250
Practice Address - Fax:813-872-6078
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst