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Individual
MS. BETTINA R MANUEL
Active
Individual
MS. BETTINA R MANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22002790
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200508620A
—
IN
01
—
22002790
STATE LICENSE
IN
Enumeration date
10/05/2006
Last updated
07/01/2008
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