Individual
LEAH MANGIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
182 SW ACADEMY ST STE 333, DALLAS, OR 97338-1996
(503) 409-4499
Mailing address
182 SW ACADEMY ST STE 333, DALLAS, OR 97338-1996
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A4325
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500708513
—
OR
Enumeration date
04/07/2007
Last updated
03/16/2020
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