Individual
DAVE MANGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CMHC
Contact information
Practice address
7069 S HIGHLAND DR STE 100, COTTONWOOD HEIGHTS, UT 84121-3731
(801) 793-0600
Mailing address
510 E 9800 S, SANDY, UT 84070-3546
(801) 793-0600
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8460542-6004
UT
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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