Provider Demographics
NPI:1083631980
Name:MANGIN, LAURA THOMPSON (MA, LPC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:THOMPSON
Last Name:MANGIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7502 STONE HILL CT
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2408
Mailing Address - Country:US
Mailing Address - Phone:214-676-6051
Mailing Address - Fax:469-366-6839
Practice Address - Street 1:7502 STONE HILL CT
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2408
Practice Address - Country:US
Practice Address - Phone:214-676-6051
Practice Address - Fax:469-366-6839
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13766101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional