Individual
MRS. STEPHANIE MANGANO SMART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
46 LOOMIS ST, APARMENT 1, MONTPELIER, VT 05602-2438
(702) 232-4922
Mailing address
46 LOOMIS ST, MONTPELIER, VT 05602-2438
(720) 232-4922
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
072.0000470
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072.0000470
STATE OF VERMONT LICENSE
VT
Enumeration date
06/29/2009
Last updated
07/23/2010
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