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1578310926
SEAN MICHAEL MANGOLD
JANESVILLE, WI
NPI
1578310926
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 20550-130)
Enumeration Date
2024-05-03
Last Update Date
2024-05-03
Business Address
Mr. SEAN MICHAEL MANGOLD
1312 BARBERRY DR STE 110
JANESVILLE, WI 53545-0589
Phone number: 608-758-1944
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Mailing Address
Mr. SEAN MICHAEL MANGOLD
1312 BARBERRY DR STE 110
JANESVILLE, WI 53545-0589
Phone number: 608-758-1944
Copy
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