Individual
RITA S MANGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
525 E 4500 S, SUITE F200, SALT LAKE CITY, UT 84107-2995
(801) 599-4254
Mailing address
1715 ZENITH AVE, SALT LAKE CITY, UT 84106-3748
(801) 599-4254
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
361835-3501
UT
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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