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Individual

MRS. JACQUELINE MARY MANTHOUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
132 MANSFIELD AVE, WILLIMANTIC, CT 06226-2027
(860) 942-5637
Mailing address
132 MANSFIELD AVE, UNITED SERVICES, INC., WILLIMANTIC, CT 06226-2027
(860) 942-5637

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
09/17/2010
Last updated
09/17/2010
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