Provider Demographics
NPI:1114666211
Name:MANGANELLO, MADELINE (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:MANGANELLO
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 PORTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1639
Mailing Address - Country:US
Mailing Address - Phone:603-921-1101
Mailing Address - Fax:
Practice Address - Street 1:26 FOREST RIDGE DR UNIT 5
Practice Address - Street 2:
Practice Address - City:ROWLEY
Practice Address - State:MA
Practice Address - Zip Code:01969-2143
Practice Address - Country:US
Practice Address - Phone:603-918-1298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty