Individual
DENISE MICHELLE MANGRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
252 RICH RD, PARK FOREST, IL 60466-1630
(773) 971-2230
Mailing address
252 RICH RD, PARK FOREST, IL 60466-1630
(773) 971-2230
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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