Provider Demographics
NPI:1912555251
Name:COHEN, MONYA JO (PSYD)
Entity Type:Individual
Prefix:
First Name:MONYA
Middle Name:JO
Last Name:COHEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 PONDSIDE TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5752
Mailing Address - Country:US
Mailing Address - Phone:202-255-7180
Mailing Address - Fax:
Practice Address - Street 1:2407 PONDSIDE TER
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-5752
Practice Address - Country:US
Practice Address - Phone:202-255-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03907103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical