Individual
MRS. JEANIE MANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISAC
Contact information
Practice address
337 N. NAVAJO DRIVE, PAGE, AZ 86040
(928) 645-6840
(928) 645-8158
Mailing address
PO BOX 4466, PAGE, AZ 86040
(928) 645-6840
(928) 645-8158
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10431
AZ
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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