Individual
RONALD LEE MANGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
104 NEW STATESIDE DR, CHAPEL HILL, NC 27516-1165
(919) 942-2803
(919) 442-1842
Mailing address
104 NEW STATESIDE DR, CHAPEL HILL, NC 27516-1165
(919) 942-2803
(919) 942-2126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
539
NC
Other
Enumeration date
12/22/2008
Last updated
08/26/2009
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