| Doctor Name: | MR. JOHN E MONGUILLOT |
| NPI Number: | 1598732554 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LP |
| License Number: | 2146 |
| Business Practice Address: | 360 Beech Street Newland, NC - 286570040 |
| Business Phone Number: | 8287335889 |
| Business Fax Number: | 8282625687 |
| Mailing Address: | Po Box 40, 360 Beech Street NEWLAND |
| State: | NC |
| Postal Code: | 286570040 |
| Phone Number: | 8287335889 |
| Fax Number: | 8282625687 |
| NPI Enumeration Date: | 03/08/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 2146 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |