Individual
JAN MARINESS MANIWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
805 GLENVISTA DR, GLENDALE, CA 91206-2619
(818) 634-9580
Mailing address
1011 N LOUISE ST APT 5, GLENDALE, CA 91207-1927
(818) 940-6923
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13864
CA
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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