Doctor Name: | MRS. EVA COLLEEN FRANCES MONDOR |
NPI Number: | 1215079645 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, NCC |
License Number: | 6401006864 |
Business Practice Address: | 231 S Main St Romeo, MI - 480655130 |
Business Phone Number: | 5863360910 |
Business Fax Number: | 5867522530 |
Mailing Address: | 231 S Main St, ROMEO |
State: | MI |
Postal Code: | 480655130 |
Phone Number: | 5863360910 |
Fax Number: | 5867522530 |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 04/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401006864 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |