Colleen Mango
Nurse Practitioner, Psych/Mental Health in New Haven, CT. Individual provider (NPI-1).
NPI number1902674831
StatusActive
Last updated in NPPESOct 9, 2024
Details
- NPI
- 1902674831
- Entity type
- Individual (NPI-1)
- Name
- Colleen Mango
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 20, 2023
- Certification date
- Oct 9, 2024
- Last updated
- Oct 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 13636 | CT | Yes |
| 163WP0809X | Registered Nurse, Psych/Mental Health, Adult | 10.158176 | CT |
Practice location
20 York StNew Haven, CT 06510-3220
Phone 203-688-4242
Mailing address
20 York StNew Haven, CT 06510-3220
Phone 203-688-4242
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