Individual
JERRICA MANAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
720 W CHEYENNE AVE STE 30, NORTH LAS VEGAS, NV 89030-7817
(702) 487-5665
Mailing address
720 W CHEYENNE AVE #30, LAS VEGAS, NV 89030-8717
(702) 487-5665
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2104134086
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104134086
—
NV
Enumeration date
04/17/2013
Last updated
04/17/2013
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