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Individual
LISA MARIE-MANGAN HAYES
Active
Individual
LISA MARIE-MANGAN HAYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
36139
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36139
CALIFORNIA BOARD OF PHYSICAL THERAPY
CA
Enumeration date
10/20/2015
Last updated
10/20/2015
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