Organization
MANGUM BEHAVIORAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRISON MANGUM KISNER MSW, LISW-CP (OWNER)
(864) 360-4341
Entity
Organization
Contact information
Practice address
7C CLEVELAND CT, GREENVILLE, SC 29607-2414
(864) 360-4341
(864) 239-6968
Mailing address
7C CLEVELAND CT, GREENVILLE, SC 29607-2414
(864) 360-4341
(864) 239-6968
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006453
SC
Other
Enumeration date
05/14/2007
Last updated
07/27/2009
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