Provider Demographics
NPI:1770923864
Name:MONROE, MARIA (MFT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MONROE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3549 CORTE DULCE
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8932
Mailing Address - Country:US
Mailing Address - Phone:760-632-9699
Mailing Address - Fax:
Practice Address - Street 1:3549 CORTE DULCE
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8932
Practice Address - Country:US
Practice Address - Phone:760-632-9699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36230106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist