Individual
DR. CHARLES MANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
24 REVIS RD, WEST LIBERTY, KY 41472-7818
(502) 436-3533
Mailing address
24 REVIS RD, WEST LIBERTY, KY 41472-7818
(502) 436-3533
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
267057
KY
Other
Enumeration date
05/24/2021
Last updated
06/05/2023
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