Provider Demographics
NPI:1669944427
Name:AQUINO, MONIQUE MORENO (LMFTA)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:MORENO
Last Name:AQUINO
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 SKYVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-6249
Mailing Address - Country:US
Mailing Address - Phone:704-975-4627
Mailing Address - Fax:
Practice Address - Street 1:1118 SKYVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-6249
Practice Address - Country:US
Practice Address - Phone:704-975-4627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11080A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist