Individual
FREDDA E MANGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
64 ALLEN ST, RUTLAND, VT 05701-4554
(802) 773-9722
(802) 773-9722
Mailing address
64 ALLEN ST, RUTLAND, VT 05701-4554
(802) 773-9722
(802) 773-9722
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000529
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007883
—
VT
01
—
356879
MVP
VT
01
—
58100
BLUE CROSS-BLUE SHIELD
VT
Enumeration date
01/16/2007
Last updated
07/08/2007
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