NPI 1013510429

Cokeshia Mango, BSW

Practitioner Contractor Baconton, GA

Practice location

Address: 192 Bowles St SW, Baconton, GA 31716-7648
Phone: (229) 407-2962

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

Other Contractor providers in Georgia →

Registry record

NPI: 1013510429
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Nov 2020
Record last updated: 18 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.