Provider Demographics
NPI:1831641786
Name:MONROE, AALIYAH A (MA)
Entity type:Individual
Prefix:
First Name:AALIYAH
Middle Name:A
Last Name:MONROE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6821 N BROAD ST
Mailing Address - Street 2:APT 2
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19126-2805
Mailing Address - Country:US
Mailing Address - Phone:267-970-1201
Mailing Address - Fax:
Practice Address - Street 1:6821 N BROAD ST
Practice Address - Street 2:APT 2
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19126-2805
Practice Address - Country:US
Practice Address - Phone:267-970-1201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional