Provider Demographics
NPI:1043750102
Name:MONTEIRO DE BARROS ABREU GOMES, PATRICIA CRISTINA
Entity Type:Individual
Prefix:DR
First Name:PATRICIA CRISTINA
Middle Name:
Last Name:MONTEIRO DE BARROS ABREU GOMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:BARROS GOMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10301 GROSVENOR PL
Mailing Address - Street 2:APT 1902
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4685
Mailing Address - Country:US
Mailing Address - Phone:574-303-2206
Mailing Address - Fax:
Practice Address - Street 1:4200 VALLEY DR
Practice Address - Street 2:SUITE 0142V
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20742-0001
Practice Address - Country:US
Practice Address - Phone:301-405-4017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGM553106H00000X
DCLMFT000204106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist