Individual
LEA MANGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCSW, MSW
Contact information
Practice address
125 S DIVISION ST, POWELL, WY 82435-2409
(307) 754-7970
Mailing address
1813 23RD ST, CODY, WY 82414-4925
(307) 272-7551
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
WY
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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