Provider Demographics
NPI:1417382078
Name:EK, MONICA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:EK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 GARRISON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-4445
Mailing Address - Country:US
Mailing Address - Phone:617-277-8107
Mailing Address - Fax:
Practice Address - Street 1:4321 FULCRUM WAY NE STE B
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-8410
Practice Address - Country:US
Practice Address - Phone:505-771-5361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health