Provider Demographics
NPI:1598317125
Name:MANNING, JANET MARY (DT)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARY
Last Name:MANNING
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4506 TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0879
Mailing Address - Country:US
Mailing Address - Phone:812-589-2485
Mailing Address - Fax:
Practice Address - Street 1:4506 TAYLOR AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0879
Practice Address - Country:US
Practice Address - Phone:812-589-2485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-13
Last Update Date:2019-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty