Healthcare Provider Details

I. General information

NPI: 1952026049
Provider Name (Legal Business Name): CHRISTIANNE THERESE MANGAN LLPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 FRANK LLOYD WRIGHT DR STE L2300
ANN ARBOR MI
48105-9484
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DR
ANN ARBOR MI
48105-9484
US

V. Phone/Fax

Practice location:
  • Phone: 734-930-4020
  • Fax: 734-769-8948
Mailing address:
  • Phone: 734-930-4020
  • Fax: 734-769-8948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6451022595
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: