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1225481146
JACKIE MANIVANH
FORT WORTH, TX
NPI
1225481146
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: TX 69071)
Enumeration Date
2016-07-15
Last Update Date
2016-07-15
Business Address
-- JACKIE MANIVANH LPC
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135-7020
Phone number: 817-238-0106
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Mailing Address
-- JACKIE MANIVANH LPC
4516 BOAT CLUB RD STE 106
FORT WORTH, TX 76135-7020
Phone number: 817-238-0106
Copy
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