Individual
ANNETTE GINA MANGIAMELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4349 JEKER DR, PLANO, TX 75074-3571
(619) 762-8909
Mailing address
4349 JEKER DR, PLANO, TX 75074-3571
(619) 762-8909
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
34289
TX
103TC0700X
Clinical Psychologist
PSY17997
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2843021
—
TX
Enumeration date
05/23/2011
Last updated
05/10/2024
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