Provider Demographics
NPI:1467757146
Name:MANGANO, DANIELLE (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:MANGANO
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 W RIDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1534
Mailing Address - Country:US
Mailing Address - Phone:484-919-3242
Mailing Address - Fax:610-265-3439
Practice Address - Street 1:3075 W RIDGE PIKE
Practice Address - Street 2:
Practice Address - City:EAGLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-1534
Practice Address - Country:US
Practice Address - Phone:484-919-3242
Practice Address - Fax:610-265-3439
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128339104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker