Individual
MRS. ALICE JEAN MANG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
4881 SUGAR MAPLE DR, 88MDG/SGHJ, WRIGHT PATTERSON AFB, OH 45433-5546
(937) 257-1368
(937) 656-1192
Mailing address
2345 SHERWOOD CT, XENIA, OH 45385-9103
(937) 374-3566
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-0004396
OH
Other
Enumeration date
11/03/2005
Last updated
07/08/2007
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