Individual
JENNIFER DIANNE MAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
14568 W BANFF LN, SURPRISE, AZ 85379-4735
(661) 803-5697
Mailing address
14568 W BANFF LN, SURPRISE, AZ 85379-4735
(661) 803-5697
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA11740
AZ
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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