Individual
LACEY NICOLE MANGANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
316 S STRATFORD AVE STE B, SANTA MARIA, CA 93454-5908
(805) 332-8446
Mailing address
316 S STRATFORD AVE STE B, SANTA MARIA, CA 93454-5908
(805) 332-8446
(805) 332-8173
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86173948
CA
Other
Enumeration date
08/04/2021
Last updated
12/27/2022
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