Individual provider · Type 1 NPI

Blaise Mongangu

Mental Health Counselor · Wheaton, IL

NPI number 1912459405 Active

Practice location

111 N County Farm Rd
Wheaton, IL 60187-3977

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1912459405

Blaise Mongangu's National Provider Identifier is 1912459405, issued on Oct 31, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Wheaton, IL. The record was last updated on Oct 31, 2016.