Provider Demographics
NPI:1356839054
Name:MANASCO, JASMINE LONG (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:LONG
Last Name:MANASCO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 SPIVEY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-2932
Mailing Address - Country:US
Mailing Address - Phone:717-433-2991
Mailing Address - Fax:
Practice Address - Street 1:447 SPIVEY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2932
Practice Address - Country:US
Practice Address - Phone:717-433-2991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013896235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist