Individual
MRS. JEAN MADELEINE MANZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3510 MESSINA DR, FARMINGTON, NM 87402-4782
(505) 716-7995
Mailing address
4773 SUNRISE CIR, FARMINGTON, NM 87401-9299
(505) 716-7995
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0101581
NM
Other
Enumeration date
09/15/2009
Last updated
03/03/2020
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