| Doctor Name: | VIRGINIA KAY MONGIELLO |
| NPI Number: | 1114240280 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPAT |
| License Number: | 2923 |
| Business Practice Address: | 112 Alexander St Suite B1 Taos, NM - 875716841 |
| Business Phone Number: | 5755788892 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1096, EL PRADO |
| State: | NM |
| Postal Code: | 875291096 |
| Phone Number: | 5757588892 |
| Fax Number: | |
| NPI Enumeration Date: | 03/03/2010 |
| NPI Last Update Date: | 03/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2923 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |