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Individual

MS. CHANDA R MONGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED; LMFT; PSY.

Contact information

Practice address
12890 HILLCREST RD, #200, DALLAS, TX 75230-1504
(214) 455-6411
Mailing address
2901 UNIVERSITY BLVD, DALLAS, TX 75205-1924
(214) 750-6411
(214) 750-6411

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001688-042409
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BCBSPROVIDER#00239B
BLUECROSS BLUE SHIELD
TX
Enumeration date
10/10/2006
Last updated
07/08/2007
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