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NPI Code Detail

MEDICARE: DR. NICOLE MAISHA MONTEIRO PH.D.

MEDICARE: DR. NICOLE MAISHA MONTEIRO PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistPSY1000332DC

General Provider Information

NPI Number : 1477693992
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE MAISHA MONTEIRO PH.D.
Provider Business Mailing Address
First Line : 4801 KENMORE AVE
Second Line : #506
City : ALEXANDRIA
State : VA
Zip : 22304-1163
Country : US
Telephone Number : 571-242-3377
Fax Number : 202-331-4402
Provider Business Practice Location Address
First Line : 2607 CONNECTICUT AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20008-1522
Country : US
Telephone Number : 202-331-4402
Fax Number : 202-331-4402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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