Individual
MRS. LISA ANN MANGOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
125 MUDDY TOES DR, ANDERSON, SC 29626-5349
(864) 353-3384
(864) 222-9715
Mailing address
127 GRAND OAK CIR, PENDLETON, SC 29670-1648
(832) 724-3524
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5605
SC
101YP2500X
Professional Counselor
67967
TX
Other
Enumeration date
09/03/2013
Last updated
01/08/2014
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