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General NPI Number Information
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NPI Number | 1558410209
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Entity Type | Individual
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Provider Name | MONICA ANN POLONYI PHD, LPC-S
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 250 ED ENGLISH DRIVE BLDG. 3 SUITE 4
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City | SHENANDOAH
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State | TX
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Zip | 77385
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Country | US
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Telephone | 936-295-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 105 MOHAWK DRIVE
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City | CONROE
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State | TX
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Zip | 77304-1258
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Country | US
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Telephone | 936-856-7733
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19204
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License Number State | TX
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