MANZA BLAINE

KOSCIUSKO, MS
NPI1770732539
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: MS  S2770)
Enumeration Date2008-09-16
Last Update Date2008-09-30
Business Address
-- MANZA BLAINE
310 AUTUMN RIDGE DR
KOSCIUSKO, MS 39090-3242
Phone number: 601-250-4815
Mailing Address
-- MANZA BLAINE
202 GALLOWAY DR
KOSCIUSKO, MS 39090-3920
Phone number:
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