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General NPI Number Information
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NPI Number | 1194301721
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Entity Type | Individual
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Provider Name | NICHOLE LE MONDS
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Gender | Female
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 1300 N CUSTER RD
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City | ALLEN
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State | TX
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Zip | 75013-3502
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Country | US
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Telephone | 726-666-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 4846 SHIELDS ST
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City | SAN DIEGO
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State | CA
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Zip | 92124-2931
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 77440
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License Number State | TX
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