Individual
MANUELA ETIENNE JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 N BROAD ST STE 7, MOORESVILLE, NC 28115-9552
(980) 892-6439
Mailing address
710 N BROAD ST STE 7, MOORESVILLE, NC 28115-9552
(980) 892-6439
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
HC7540
NC
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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