Individual
JENNIFER MANNINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
127 N RIVER ST, FENTON, MI 48430-3800
(810) 309-9355
(810) 750-1152
Mailing address
127 N RIVER ST, FENTON, MI 48430-3800
(810) 309-9355
(810) 750-1152
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401222784
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6401222784
LICENSED PROFESSIONAL COUNSELOR
MI
05
—
6401222784
—
MI
Enumeration date
07/21/2022
Last updated
07/21/2022
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