Provider Demographics
NPI:1942915681
Name:MONTEIRO, MAUREEN ELIZABETH
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:MONTEIRO
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 1:4440 WILLARD AVE APT 328
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3748
Mailing Address - Country:US
Mailing Address - Phone:508-517-9221
Mailing Address - Fax:
Practice Address - Street 1:5225 WISCONSIN AVE NW # 201A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2014
Practice Address - Country:US
Practice Address - Phone:202-362-7814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMT1630225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist