Individual
DR. MARY JANE MANGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 S SHOOP AVE, WAUSEON, OH 43567-1702
(419) 335-2015
(419) 330-2774
Mailing address
725 S SHOOP AVE, WAUSEON, OH 43567-1702
(419) 335-2015
(419) 330-2774
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
35058814
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0860733
—
OH
Enumeration date
05/25/2006
Last updated
07/28/2016
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