Individual
ERICA CHARELLE MANGRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
74 PINE HILL CT, BRODNAX, VA 23920-3330
(434) 637-0914
Mailing address
74 PINE HILL CT, BRODNAX, VA 23920-3330
(434) 637-0914
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701012779
VA
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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