Provider Demographics
NPI:1346336955
Name:MANGANIELLO, APRIL DAWN (MS)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:DAWN
Last Name:MANGANIELLO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:PRITA
Other - Last Name:MANGANIELLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:33 CONOMO POINT RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MA
Mailing Address - Zip Code:01929-1040
Mailing Address - Country:US
Mailing Address - Phone:978-768-7934
Mailing Address - Fax:978-768-2589
Practice Address - Street 1:33 CONOMO POINT RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MA
Practice Address - Zip Code:01929-1040
Practice Address - Country:US
Practice Address - Phone:978-768-7934
Practice Address - Fax:978-768-2589
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC 854101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD774823OtherTUFTS HEALTH PLAN
MALMFT 351OtherLICENSE
MALM0281OtherBLUE CROSS/BLUE SHIELD
MALMHC 854OtherLICENSE#