Individual
LORI BETH MANGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
541 BUTTERMILK PIKE STE 200, CRESCENT SPRINGS, KY 41017-1696
(859) 869-2023
(561) 401-9196
Mailing address
103 FOX MEADOW RUN, JUPITER, FL 33458-5504
(859) 250-6898
(561) 401-9196
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
252940
KY
1041C0700X
Clinical Social Worker
292540
KY
1041C0700X
Clinical Social Worker
SW17168
FL
Other
Enumeration date
11/22/2017
Last updated
12/18/2023
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