Individual
JADE MANGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
7992 S 7110 W, WEST JORDAN, UT 84088-5094
(801) 252-7036
Mailing address
7992 S 7110 W, WEST JORDAN, UT 84088-5094
(801) 252-7036
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4995763-3502
UT
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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