Individual
VIRGINIA KAY MONGIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPAT
Contact information
Practice address
112 ALEXANDER ST, SUITE B1, TAOS, NM 87571-6841
(575) 578-8892
Mailing address
PO BOX 1096, EL PRADO, NM 87529-1096
(575) 758-8892
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2923
NM
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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