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Individual
MRS. JESSICA LYNN MANGAN
Active
Individual
MRS. JESSICA LYNN MANGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, LLP
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401009818
MI
101YP2500X
Professional Counselor
6401009818
MI
103T00000X
Psychologist
6361000886
MI
Other
Enumeration date
12/13/2006
Last updated
09/24/2024
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