Provider Demographics
NPI:1912236936
Name:FETTA-MONIZ, BARBARA ANN (MA)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:FETTA-MONIZ
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 1:125 SMITH AVE UNIT 5F
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-1637
Mailing Address - Country:US
Mailing Address - Phone:401-261-1060
Mailing Address - Fax:
Practice Address - Street 1:194 WATERMAN ST STE 7
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4015
Practice Address - Country:US
Practice Address - Phone:401-261-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health