Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
OMAR MANGRUM, EDD
ActiveOMAR MANGRUM, EDD is a Psychologist healthcare provider located in GRAND RAPIDS, Michigan. NPI 1457389157 is currently active in the NPPES registry. Verify at CMS.
Psychologist · GRAND RAPIDS, MI
Registration Details
- NPI Number
- 1457389157
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 29, 2006 (20.100961541965 yrs)
- Last Updated
- Jul 8, 2007
- License
-
6301005399 (MI)
Practice Information
- Address
-
161 OTTAWA AVE NWSUITE 300CGRAND RAPIDS, MI, 495032701Browse MI providers · Browse ZIP 49503
- Phone
- 6164580692
- Fax
- 6164588129
- Primary Specialty
-
Psychologist
103T00000X
Other Psychologist Providers in GRAND RAPIDS, MI
| Name | Credential | NPI |
|---|---|---|
| DR. MARY ELIZABETH VANDERGOOT | PHD | 1447220819 |
| DR. GERALD F MCKEEGAN | PHD | 1508810219 |
| CAROL SUNDAY-RASCHE | MA | 1104872480 |
| GARY A BURKHART | PH.D. | 1598712184 |
| JAMES J BOTTENHORN | MA, LLP | 1639126378 |
| RICHARD BAEZ | PSY.D., LLP | 1841237765 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.