Richard M Mangongo, SOCIAL WORK INTERN

NPI #1316599574 in Jbsa Ft Sam Houston, Texas

Provider Information

NPI Number: 1316599574
Entity Type: Individual
Name: Richard M Mangongo, SOCIAL WORK INTERN
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Credential: SOCIAL WORK INTERN
Enumeration Date: Jul 9, 2019
Last Updated: Jul 9, 2019

Practice Location

Address: 3551 ROGER BROOKE DR
City: Jbsa Ft Sam Houston
State: Texas
ZIP Code: 78234-4504
Phone: (210) 539-6150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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