Provider Demographics
NPI:1124228663
Name:PROCELL MONGER, JAYME (BS)
Entity Type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:
Last Name:PROCELL MONGER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3428
Mailing Address - Country:US
Mailing Address - Phone:970-986-0445
Mailing Address - Fax:
Practice Address - Street 1:1020 GRAND AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3428
Practice Address - Country:US
Practice Address - Phone:970-986-0445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor