Individual
MS. JANIE M. MANTOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1020 TURKEY MOUNTAIN RD, BEDFORD, VA 24523-6635
(540) 586-8146
(540) 587-7647
Mailing address
PO BOX 628, BEDFORD, VA 24523-0628
(540) 586-8146
(540) 587-7647
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003979
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010219779
VIRGINIA PREMIER
—
05
—
010219779
—
VA
01
—
183482
ANTHEM
—
01
—
233212
COMPSYCH CORP
—
01
—
338400
VALUE OPTIONS
—
01
—
7664336
AETNA
—
Enumeration date
01/23/2008
Last updated
10/02/2008
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