Provider Demographics
NPI:1811330194
Name:ANNE M MENOTTI, PH.D.LLC
Entity type:Organization
Organization Name:ANNE M MENOTTI, PH.D.LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MENOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-987-7300
Mailing Address - Street 1:19500 CLUB HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3002
Mailing Address - Country:US
Mailing Address - Phone:301-987-7300
Mailing Address - Fax:301-977-9319
Practice Address - Street 1:19500 CLUB HOUSE RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-3002
Practice Address - Country:US
Practice Address - Phone:301-987-7300
Practice Address - Fax:301-977-9319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0348103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty