Individual
MELISSA INEZ MANGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
220 E ASH ST, HUNTINGTON, TX 75949-8648
(936) 876-2273
Mailing address
PO BOX 503, CHIRENO, TX 75937-0503
(936) 645-3323
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214749
TX
Other
Enumeration date
02/12/2019
Last updated
02/12/2019
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