Individual
MRS. SHANTI KAY MANZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
5476 KOLOA ROAD, 2F, KOLOA, HI 96756
(808) 639-7255
Mailing address
PO BOX 1075, KOLOA, HI 96756-1075
(808) 639-7255
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
—
—
1041C0700X
Clinical Social Worker
23542
CA
1041C0700X
Clinical Social Worker
Primary
3860
HI
Other
Enumeration date
12/10/2009
Last updated
03/04/2019
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