Individual
JEANETTE MANCHESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PC
Contact information
Practice address
399 E MAIN ST, COLUMBUS, OH 43215-5384
(614) 355-8550
(614) 355-8593
Mailing address
PO BOX 715194, COLUMBUS, OH 43271-5194
(614) 355-8004
(614) 355-0509
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C.1100560
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08258
—
OH
Enumeration date
10/02/2009
Last updated
08/25/2011
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