Provider Demographics
NPI:1265241301
Name:SANTANA MONESTIME, ANNE-LISE
Entity type:Individual
Prefix:
First Name:ANNE-LISE
Middle Name:
Last Name:SANTANA MONESTIME
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:SANTANAANNELISE681@GMAIL.COM
Mailing Address - Street 2:733 RIVER STREET APT 36
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-6414
Mailing Address - Country:US
Mailing Address - Phone:857-415-0525
Mailing Address - Fax:
Practice Address - Street 1:SANTANAANNELISE681@GMAIL.COM
Practice Address - Street 2:733 RIVER STREET APT 36
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-6414
Practice Address - Country:US
Practice Address - Phone:857-415-0525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician