Provider Demographics
NPI:1700974086
Name:GUILLEN, MONICA JOANNA (PT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:JOANNA
Last Name:GUILLEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8702 DREXEL HILL PL
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20886-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19231 MONTGOMERY VILLAGE AVE
Practice Address - Street 2:SUITE D21
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-5023
Practice Address - Country:US
Practice Address - Phone:301-977-6777
Practice Address - Fax:301-977-0108
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist