Individual
MICHAEL MANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1165 E 300 N, PROVO, UT 84606-3539
(801) 373-4760
(801) 373-0639
Mailing address
702B S CARTERVILLE RD, OREM, UT 84097-6642
(801) 735-1229
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
284431-3502
UT
1041C0700X
Clinical Social Worker
284431-3506
UT
Other
Enumeration date
07/08/2021
Last updated
05/26/2023
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