| NPI | 1477201721 |
|---|---|
| Doing Business As | KELLI MANGOLD, LCSW |
| Entity Type | Organization |
| Authorized Contact | KELLI MANGOLD Owner 806-471-0334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2022-03-16 |