Individual
EBONY LAUREN MANZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
9541 JULIAN CLARK AVE STE 208, HUNTERSVILLE, NC 28078-3486
(704) 796-9037
Mailing address
PO BOX 53, PHILLIPSBURG, NJ 08865-0053
(201) 772-8417
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
44SL06985900
NJ
1041C0700X
Clinical Social Worker
Primary
P020429
NC
1041S0200X
School Social Worker
01739993
NJ
Other
Enumeration date
04/17/2024
Last updated
04/17/2024
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