Provider Demographics
NPI:1689296287
Name:MONTERO, JENNY
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:MONTERO
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 1:2300 N SHERMAN CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5161
Mailing Address - Country:US
Mailing Address - Phone:786-447-7551
Mailing Address - Fax:
Practice Address - Street 1:2300 N SHERMAN CIR APT 101
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5161
Practice Address - Country:US
Practice Address - Phone:786-447-7551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician