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Individual

OCTAVIOUS MONIQUE DANGERFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3633 PENDLETON CT, HEARTLAND, TX 75126-2590
(214) 815-5672
Mailing address
3633 PENDLETON CT, HEARTLAND, TX 75126-2590
(214) 815-5672

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
172A00000X
Driver
261QD1600X
Developmental Disabilities Clinic/Center
343900000X
Non-emergency Medical Transport (VAN)
Primary
347C00000X
Private Vehicle

Other

Enumeration date
02/27/2024
Last updated
02/27/2024
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