Individual
MONIQUE ADRIANA BULETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT, PT, IBCLC
Contact information
Practice address
1308 BIRKENHEAD CT, DALLAS, TX 75204-6102
(972) 987-0447
Mailing address
1308 BIRKENHEAD CT, DALLAS, TX 75204-6102
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-311206
TX
2251P0200X
Pediatric Physical Therapist
1311189
TX
Other
Enumeration date
07/28/2022
Last updated
07/19/2023
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