Individual
STEPHANIE MANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
18596 LEE HWY STE B, ABINGDON, VA 24210-8004
(276) 525-6043
Mailing address
1713 MOUNT VERNON RD SW, ROANOKE, VA 24015-2904
(540) 521-7918
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119004489
VA
Other
Enumeration date
10/09/2017
Last updated
10/09/2017
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