Provider Demographics
NPI:1477384667
Name:JEFFRIES, MONZARLL0 QUINITO
Entity type:Individual
Prefix:
First Name:MONZARLL0
Middle Name:QUINITO
Last Name:JEFFRIES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9520 BIRCHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-1415
Mailing Address - Country:US
Mailing Address - Phone:216-647-6433
Mailing Address - Fax:216-647-6434
Practice Address - Street 1:9520 BIRCHWOOD RD
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-1415
Practice Address - Country:US
Practice Address - Phone:216-647-6433
Practice Address - Fax:216-647-6434
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical