Mangus-Hayden, Mallori Nicole

Mangus-Hayden, Mallori Nicole is an sole proprietor health care provider with primary practice located at 2458 E 11Th St , Odessa TX 79761-4236. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Mangus-Hayden, Mallori Nicole can be contacted via phone (432) 582-2444.

Contact Information

Primary practice address
2458 E 11Th St Odessa TX 79761-4236
Phone: (432) 582-2444
Fax: (432) 582-2449
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 20187 Texas

Profile Details

NPI number 1740395193
LBN Legal business name Mangus-Hayden, Mallori Nicole
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 19th, 2006
Last updated May 22nd, 2015 - about 9 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 1740395193 NPPES
Texas MEDICAID 179089101

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