Individual
MRS. KELLI ANN MANZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C, LICSW
Contact information
Practice address
142 N QUEEN ST, MARTINSBURG, WV 25401
(304) 596-0486
(304) 760-5945
Mailing address
142 N QUEEN ST, MARTINSBURG, WV 25401-3312
(304) 596-0486
(304) 760-5945
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
17093
MD
1041C0700X
Clinical Social Worker
Primary
DP00944880
WV
Other
Enumeration date
12/28/2009
Last updated
06/13/2018
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