JACKIE MANIVANH

FORT WORTH, TX
NPI1225481146
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: TX  69071)
Enumeration Date2016-07-15
Last Update Date2016-07-15
Business Address
-- JACKIE MANIVANH LPC
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135-7020
Phone number: 817-238-0106
Mailing Address
-- JACKIE MANIVANH LPC
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135-7020
Phone number: 817-238-0106