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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RYAN MANGUM, PHD

Active

RYAN MANGUM, PHD is a Clinical Neuropsychologist healthcare provider located in BOISE, Idaho. NPI 1790311157 is currently active in the NPPES registry. Verify at CMS.

Clinical Neuropsychologist · BOISE, ID

Registration Details

NPI Number
1790311157
Provider Type
Individual
Gender
Male
NPI Issued
Mar 18, 2020 (6.4390905536759 yrs)
Last Updated
Mar 29, 2023
Licenses
PY61070460 (WA)
6301018219 (MI)
PY61070460 (WA)
PSY-203778 (ID)

Practice Information

Address
600 N ROBBINS RD
BOISE, ID, 837024565
Browse ID providers · Browse ZIP 83702
Phone
2083819037
Primary Specialty
Clinical Neuropsychologist
103G00000X
Additional Specialty
Clinical Psychologist
Additional Specialty
Clinical Psychologist
Additional Specialty
Clinical Neuropsychologist

Other Clinical Neuropsychologist Providers in BOISE, ID

Name Credential NPI
DANAE PEREZ-CAHILL PH.D. 1780612986
DR. HAROLD DALE PATTERSON PH.D. 1962414631
MR. ROBERT F. CALHOUN PHD 1376697946
CRAIG W. BEAVER PH.D. 1225176498
DR. ELENA THERESSA HARLAN DREWEL PH.D. 1538490834
BRIENNE M DYER PSY.D. 1659631562
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.