Individual
ANGELA MARIE MANDEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
2766 E 3300 S, SALT LAKE CITY, UT 84109-2819
(801) 467-5437
(801) 466-6643
Mailing address
2766 E 3300 S, SALT LAKE CITY, UT 84109-2819
(801) 467-5437
(801) 466-6643
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6145420-3502
UT
Other
Enumeration date
05/15/2006
Last updated
10/29/2009
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