Individual
DR. JESSICA L MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
15 IONIA AVE SW, SUITE 500, GRAND RAPIDS, MI 49503
(616) 202-1234
Mailing address
15 IONIA AVE SW, SUITE 500, GRAND RAPIDS, MI 49503
(616) 365-8920
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
20042522A
IN
103T00000X
Psychologist
Primary
6301016638
MI
103TC1900X
Counseling Psychologist
20042522A
IN
Other
Enumeration date
04/21/2011
Last updated
01/26/2023
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