Individual
KERRI MANGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
48 WILDWOOD LN, LOGAN, WV 25601-4059
(229) 785-5913
Mailing address
48 WILDWOOD LN, LOGAN, WV 25601-4059
(229) 785-5913
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/10/2026
Last updated
06/10/2026
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