Provider Demographics
NPI:1942846027
Name:MENDEZ, MARI A (MSW)
Entity Type:Individual
Prefix:MS
First Name:MARI
Middle Name:A
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 PEPPERTREE LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4034
Mailing Address - Country:US
Mailing Address - Phone:630-677-5923
Mailing Address - Fax:
Practice Address - Street 1:246 PEPPERTREE LN
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-4034
Practice Address - Country:US
Practice Address - Phone:630-677-5923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician