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Individual

MS. JEANETTE MANLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.C.

Contact information

Practice address
1235 E HARMONT DR, PHOENIX, AZ 85020-3864
(602) 331-1470
(602) 678-5803
Mailing address
1235 E. HARMONT DR., PHOENIX, AZ 85020
(602) 331-1470
(602) 678-5803

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-0860
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPC-0860
AZ BOARD OF BEHAVIORAL HEALTH EXAMINERS
AZ
Enumeration date
09/03/2008
Last updated
09/03/2008
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