Provider Demographics
NPI:1073032553
Name:MONTFORT, MARIE-EMMANUELLE ALEXANDRA (BSW)
Entity Type:Individual
Prefix:
First Name:MARIE-EMMANUELLE
Middle Name:ALEXANDRA
Last Name:MONTFORT
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-5817
Mailing Address - Country:US
Mailing Address - Phone:908-937-8799
Mailing Address - Fax:
Practice Address - Street 1:200 W 9TH ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-4246
Practice Address - Country:US
Practice Address - Phone:908-937-8799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker