Individual
CANDICE LYNN MANGERIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1462 ROWLAND AVE NE, CANTON, OH 44705-1569
(330) 906-9663
Mailing address
1462 ROWLAND AVE NE, CANTON, OH 44705-1569
(330) 906-9663
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0221626
—
OH
Enumeration date
10/16/2020
Last updated
10/16/2020
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