Individual
DR. JONATHAN MANGOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
260 S 1ST ST, S 1, ZIONSVILLE, IN 46077-1602
(317) 873-9573
Mailing address
255 N MAIN ST, ZIONSVILLE, IN 46077-1434
(317) 873-9573
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
20040052A
IN
103TC0700X
Clinical Psychologist
Primary
20040052A
IN
Other
Enumeration date
11/01/2006
Last updated
06/13/2012
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