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1356490080
JERRY J. MUNGADZE
BEDFORD, TX
NPI
1356490080
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: TX 10315)
Enumeration Date
2007-01-10
Last Update Date
2007-07-08
Business Address
JERRY J. MUNGADZE PHD., LPC
2040 BEDFORD RD STE 200
BEDFORD, TX 76021-5871
Phone number: 817-354-1389
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Mailing Address
JERRY J. MUNGADZE PHD., LPC
2040 BEDFORD RD STE 200
BEDFORD, TX 76021-5871
Phone number: 817-354-1389
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