Individual
MARY LYNN MANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
121 SIMPSON ST, MORGANTOWN, WV 26501-5921
(681) 285-1133
Mailing address
24 PHEASANT RIDGE RD, BRIDGEPORT, WV 26330-9325
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2648
WV
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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