Individual
KANITA MANGINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Mailing address
2 WATERSIDE XING STE 401, WINDSOR, CT 06095-1587
(860) 731-5522
(860) 731-5536
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
5357
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2019
Last updated
09/02/2020
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