Individual
JESSICA MARIE MANGINELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5884 S IVANHOE AVE, YPSILANTI, MI 48197-7112
(805) 509-0451
Mailing address
5884 S IVANHOE AVE, YPSILANTI, MI 48197-7112
(805) 509-0451
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86294229
CA
Other
Enumeration date
07/30/2022
Last updated
07/30/2022
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