Individual
NICOLE M MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
8390 LBJ FREEWAY, SUITE 1000, DALLAS, TX 75243-1288
(214) 361-2100
(214) 361-2145
Mailing address
P.O. BOX 537, SULPHUR SPRINGS, TX 75483-0537
(214) 361-2100
(214) 361-2145
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
33427
TX
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
06/10/2006
Last updated
10/18/2024
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