Provider Demographics
NPI:1821763095
Name:MONAHAN, CECELIA MARIE (CT)
Entity Type:Individual
Prefix:
First Name:CECELIA
Middle Name:MARIE
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 E WILSON BRIDGE RD STE A5
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2358
Mailing Address - Country:US
Mailing Address - Phone:614-547-9233
Mailing Address - Fax:
Practice Address - Street 1:71 E WILSON BRIDGE RD STE A5
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2358
Practice Address - Country:US
Practice Address - Phone:614-547-9233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program