Individual
HEATHER M MANGOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
26 WINDMILL RD, ELLINGTON, CT 06029-2121
(860) 871-7749
Mailing address
26 WINDMILL RD, ELLINGTON, CT 06029-2121
(860) 871-7749
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
003704
CT
Other
Enumeration date
08/10/2011
Last updated
08/28/2011
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