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1164142212
DENISE MICHELLE MANGRUM
PARK FOREST, IL
NPI
1164142212
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2022-08-30
Last Update Date
2022-08-30
Business Address
DENISE MICHELLE MANGRUM DT
252 RICH RD
PARK FOREST, IL 60466-1630
Phone number: 773-971-2230
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Mailing Address
DENISE MICHELLE MANGRUM DT
252 RICH RD
PARK FOREST, IL 60466-1630
Phone number: 773-971-2230
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