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Individual

ISAAC GRAY MANIS III

Active
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Individual

ISAAC GRAY MANIS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1368
KY
101YA0400X
Addiction (Substance Use Disorder) Counselor
1368
KY
101YM0800X
Mental Health Counselor
1368
KY
1041C0700X
Clinical Social Worker
Primary
1368
KY

Other

Enumeration date
10/24/2006
Last updated
07/13/2020
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