| NPI | 1558605113 |
|---|---|
| Professional Name | JAMIE MAMMENGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-64820) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA 60985147) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2024-08-12 |