Individual
ADELINE T MANGWA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
10440 LITTLE PATUXENT PKWY STE 300, COLUMBIA, MD 21044-3648
(240) 203-4457
Mailing address
12912 CONAMAR DR UNIT 1931, HAGERSTOWN, MD 21742-7505
(240) 898-7692
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R230111
MD
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497015283
—
MD
Enumeration date
05/25/2012
Last updated
04/03/2024
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