Doctor Name: | MS. JAN MANN |
NPI Number: | 1023378080 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 66446 |
Business Practice Address: | 13624 John F Kennedy St Manor, TX - 786533939 |
Business Phone Number: | 5129341159 |
Business Fax Number: | |
Mailing Address: | 13624 John F Kennedy St, MANOR |
State: | TX |
Postal Code: | 786533939 |
Phone Number: | 5129341159 |
Fax Number: | |
NPI Enumeration Date: | 05/24/2012 |
NPI Last Update Date: | 07/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 66446 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |