Individual
DESIREE A MANGONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
8247 HWY E, PILOT GROVE, MO 65276
(660) 834-3519
Mailing address
8247 HWY E, PILOT GROVE, MO 65276
(660) 834-3519
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2000158040
MO
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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