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Individual
TIA MANIERRE
Active
Individual
TIA MANIERRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
106632
TX
1041C0700X
Clinical Social Worker
Primary
106632
TX
1041C0700X
Clinical Social Worker
149029753
IL
Other
Enumeration date
01/04/2022
Last updated
07/31/2025
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