Individual
KIMBERLY MANRIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S, L.P.C., A.T.R
Contact information
Practice address
5798 DEER TRAIL DR, TRAVERSE CITY, MI 49684-8479
(231) 709-3177
Mailing address
5798 DEER TRAIL DR, TRAVERSE CITY, MI 49684-8479
(231) 709-3177
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
950
NH
101YP2500X
Professional Counselor
Primary
6401013605
MI
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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