Provider Demographics
NPI:1225220825
Name:PASCUAL, JENNIFER MANANGHAYA (RPT)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:MANANGHAYA
Last Name:PASCUAL
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 O' ROURKE DR.
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079
Mailing Address - Country:US
Mailing Address - Phone:816-858-5222
Mailing Address - Fax:816-431-0247
Practice Address - Street 1:220 O' ROURKE DR.
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079
Practice Address - Country:US
Practice Address - Phone:816-858-5222
Practice Address - Fax:816-431-0247
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005026644225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist