Individual
KAITLYN MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
6010 W AMARILLO BLVD RM 2508, AMARILLO, TX 79106-1990
(806) 355-9703
Mailing address
6010 W AMARILLO BLVD RM 2508, AMARILLO, TX 79106-1990
(806) 355-9703
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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