Provider Demographics
NPI:1992498745
Name:MONJE, MARIA JESUS
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:JESUS
Last Name:MONJE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 BLITHEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-2634
Mailing Address - Country:US
Mailing Address - Phone:508-808-9598
Mailing Address - Fax:
Practice Address - Street 1:115 BLITHEWOOD AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-2634
Practice Address - Country:US
Practice Address - Phone:508-808-9598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator