Provider Demographics
NPI:1154079267
Name:MANY, JAMMEL JOUNIOR
Entity Type:Individual
Prefix:
First Name:JAMMEL
Middle Name:JOUNIOR
Last Name:MANY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-2665
Mailing Address - Country:US
Mailing Address - Phone:754-301-1721
Mailing Address - Fax:
Practice Address - Street 1:112 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-2665
Practice Address - Country:US
Practice Address - Phone:754-301-1721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101200000XBehavioral Health & Social Service ProvidersDrama Therapist