Individual
LAURA ELIZABETH MANGUM-CHILDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
187 HIGH ST NE, SUITE #216, SALEM, OR 97301-3689
(971) 600-4358
Mailing address
187 HIGH ST NE, SUITE #216, SALEM, OR 97301-3689
(971) 600-4358
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9923045
CO
Other
Enumeration date
05/21/2013
Last updated
10/14/2014
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