Doctor Name: | DR. MARY JANE MANGEN |
NPI Number: | 1205882263 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 35058814 |
Business Practice Address: | 725 S Shoop Ave Wauseon, OH - 435671702 |
Business Phone Number: | 4193352015 |
Business Fax Number: | 4193302649 |
Mailing Address: | 725 S Shoop Ave, WAUSEON |
State: | OH |
Postal Code: | 435671702 |
Phone Number: | 4193352015 |
Fax Number: | 4193302649 |
NPI Enumeration Date: | 05/25/2006 |
NPI Last Update Date: | 01/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084P0804X |
License Number: | 35058814 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Child & Adolescent Psychiatry |
Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |