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Individual

DEA NICOLE MANGES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
347 MIDWAY BLVD STE 210, ELYRIA, OH 44035-2496
(440) 324-5555
Mailing address
314 HIGH ST, ELYRIA, OH 44035-3144
(440) 308-8665

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2309988
OH

Other

Enumeration date
01/12/2021
Last updated
09/27/2023
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