Individual
JENNIFER MANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
825 S TAYLOR AVE, SAINT LOUIS, MO 63110-1567
(314) 977-0150
(314) 977-0023
Mailing address
825 S TAYLOR AVE, SAINT LOUIS, MO 63110-1567
(314) 977-0150
(314) 977-0023
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
468375506
—
MO
Enumeration date
01/15/2010
Last updated
08/24/2010
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