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Individual

JUSTIN MANGOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5477 MOORETOWN RD, WILLIAMSBURG, VA 23188-2108
(757) 565-0106
Mailing address
5477 MOORETOWN RD, WILLIAMSBURG, VA 23188-2108

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003834
VA

Other

Enumeration date
09/07/2018
Last updated
09/07/2018
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