Provider Demographics
NPI:1669900262
Name:MONRROY, LETICIA (MFTA)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:MONRROY
Suffix:
Gender:F
Credentials:MFTA
Other - Prefix:
Other - First Name:LETICIA
Other - Middle Name:
Other - Last Name:MONRROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1204
Mailing Address - Country:US
Mailing Address - Phone:818-242-8403
Mailing Address - Fax:
Practice Address - Street 1:1205 E INTERNATIONAL AIRPORT RD STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1409
Practice Address - Country:US
Practice Address - Phone:907-570-6382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AK183167106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program