Individual
DEIDRE A MANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW LCAC
Contact information
Practice address
635 N MAIN ST, WICHITA, KS 67203-3602
(316) 660-7500
(316) 660-1897
Mailing address
271 W 3RD ST STE 600, WICHITA, KS 67202-1223
(316) 660-7600
(316) 941-5075
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
607
KS
104100000X
Social Worker
8110
KS
1041C0700X
Clinical Social Worker
Primary
4396
KS
Other
Enumeration date
06/27/2011
Last updated
10/25/2018
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