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General NPI Number Information
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NPI Number | 1417576166
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Entity Type | Organization
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Legal Business Name | MONOPATIA, INC
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 04/13/2023
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Provider Practice Location Address
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Address Line | 2719 PULASKI HWY STE 6
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City | EDGEWOOD
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State | MD
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Zip | 21040-1315
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Country | US
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Telephone | 410-618-6779
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Fax |
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Provider Business Mailing Address
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Address Line | 2719 PULASKI HWY STE 6
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City | EDGEWOOD
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State | MD
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Zip | 21040-1315
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Country | US
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Telephone | 410-618-6779
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | EDWIN CHUKU
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Credential |
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Telephone | 410-618-6779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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