Individual
MRS. CHRISSONDRIA LYNN MANGRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
213 W MCDONALD AVE, MAN, WV 25635-1112
(304) 583-9299
Mailing address
213 W MCDONALD AVE, MAN, WV 25635-1112
(304) 583-9299
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-0607
WV
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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