Provider Demographics
NPI:1952574766
Name:MANGINI, NANCY (OTR/L)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MANGINI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1178 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3257
Mailing Address - Country:US
Mailing Address - Phone:614-395-1448
Mailing Address - Fax:
Practice Address - Street 1:1178 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3257
Practice Address - Country:US
Practice Address - Phone:614-395-1448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-12
Last Update Date:2008-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.000472172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHOT.000472OtherOHIO OCCUPATIONAL THERAPY