Individual
LISA M MANES-MANKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
10 ELFEN GLEN ST, VAN BUREN, AR 72956-2222
(479) 420-0817
Mailing address
10 ELFEN GLEN ST, VAN BUREN, AR 72956-2222
(794) 420-0817
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
212
AK
235Z00000X
Speech-Language Pathologist
2350
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156334721
—
AR
05
—
40381
—
AK
Enumeration date
03/21/2007
Last updated
06/18/2024
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