Individual
MANI FAEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
610 W BROADWAY AVE STE L-1, JACKSON, WY 83001-8213
(307) 733-3908
(307) 734-0017
Mailing address
PO BOX 11390, JACKSON, WY 83002-1390
(307) 733-3908
(307) 734-0017
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
89498
CA
Other
Enumeration date
12/12/2016
Last updated
06/30/2022
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