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Individual

MRS. JANTINA ANNA MANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
130 HIGHWAY 20 SOUTH, THERMOPOLIS, WY 82443
(307) 864-9227
(307) 864-2296
Mailing address
107 CHEVY CHASE, THERMOPOLIS, WY 82443
(307) 864-2607

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP510
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1770688871
WY
Enumeration date
08/28/2008
Last updated
08/28/2008
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