Mangum, Connie West

Mangum, Connie West is an individual health care provider with primary practice located at 2823 Arlington Ave , Fayetteville NC 28303-5403. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Mangum, Connie West can be contacted via phone (910) 483-4002.

Contact Information

Primary practice address
2823 Arlington Ave Fayetteville NC 28303-5403
Fax: (910) 483-8462
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 2463 North Carolina

Profile Details

NPI number 1457397044
LBN Legal business name Mangum, Connie West
Credentials MS,CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457397044 NPPES
North Carolina Other 53812 BCBS PROVIDER #
North Carolina MEDICAID 7412046 BCBS PROVIDER #

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