Individual
MR. SEAN MICHAEL MANGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1312 BARBERRY DR STE 110, JANESVILLE, WI 53545-0589
(608) 758-1944
Mailing address
1312 BARBERRY DR STE 110, JANESVILLE, WI 53545-0589
(608) 758-1944
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20550-130
WI
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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