Individual
JAKENIQUA COSHELL MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2715 COLONIAL DR, COLUMBIA, SC 29203-6818
(803) 898-7174
(803) 898-2194
Mailing address
2715 COLONIAL DR, COLUMBIA, SC 29203-6818
(803) 898-7174
(803) 898-2194
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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