Individual
AMI MANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4590 NASH WAY, SAINT LOUIS, MO 63110-1020
(314) 362-1930
Mailing address
111 PARK ST APT 7S, NEW HAVEN, CT 06511-5455
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2026027276
MO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/27/2026
Last updated
06/16/2026
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