Provider Demographics
NPI:1669658191
Name:MANCINI, JOLENE ANGELA
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:ANGELA
Last Name:MANCINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 CREST AVE
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1106
Mailing Address - Country:US
Mailing Address - Phone:703-505-7647
Mailing Address - Fax:
Practice Address - Street 1:3103 CREST AVE
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1106
Practice Address - Country:US
Practice Address - Phone:703-505-7647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist