Nicole M Mangum, PhD
Psychologist in Dallas, TX. Individual provider (NPI-1).
NPI number1790727451
StatusActive
Last updated in NPPESOct 18, 2024
Details
- NPI
- 1790727451
- Entity type
- Individual (NPI-1)
- Name
- Nicole M Mangum
- Credential
- PhD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 10, 2006
- Last updated
- Oct 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | – | – | Yes |
| 103G00000X | Clinical Neuropsychologist | 33427 | TX |
Practice location
8390 Lbj FreewaySuite 1000
Dallas, TX 75243-1288
Phone 214-361-2100 · Fax 214-361-2145
Mailing address
P.O. Box 537Sulphur Springs, TX 75483-0537
Phone 214-361-2100 · Fax 214-361-2145
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