Provider Demographics
NPI:1679329379
Name:AGBAYANI, MONAMARIE RASQUERO (BC-HIS)
Entity type:Individual
Prefix:
First Name:MONAMARIE
Middle Name:RASQUERO
Last Name:AGBAYANI
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7175 SPRING MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3819
Mailing Address - Country:US
Mailing Address - Phone:702-253-9030
Mailing Address - Fax:
Practice Address - Street 1:7175 SPRING MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3819
Practice Address - Country:US
Practice Address - Phone:702-253-9030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVHAS-3246237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist