Individual
MRS. DESTINY MILLER MANGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
165 RIDGECREST CIR, CLAYTON, GA 30525-4110
(678) 357-5849
Mailing address
165 RIDGECREST CIR, CLAYTON, GA 30525-4110
(678) 357-5849
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
PCET003509
GA
235Z00000X
Speech-Language Pathologist
Primary
SLP012443
GA
Other
Enumeration date
01/20/2022
Last updated
01/01/2024
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