NPI | 1396100863 |
---|---|
Former Legal Business Name | JOSEPH D. MANGINE, PH.D. |
Entity Type | Organization |
Authorized Contact | JOSEPH DONALD MANGINE Owner 413-218-1105 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OH 7370) |
Enumeration Date | 2015-12-28 |
Last Update Date | 2021-01-13 |