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Individual

MRS. JENNIFER MICHELLE MANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L, CHT

Contact information

Practice address
HWY 491 NORTH, NORTHERN NAVAJO MEDICAL CENTER, SHIPROCK, NM 87420
(505) 368-7089
(505) 368-7091
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-7089
(505) 368-7091

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103032
MN
225XH1200X
Hand Occupational Therapist
201311087
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
909430000
MN
Enumeration date
04/11/2007
Last updated
07/24/2015
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