Individual
MRS. LISA MARIE MANERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2273 E GALA ST STE 100, MERIDIAN, ID 83642-7289
(208) 898-8999
(208) 898-8989
Mailing address
2273 E GALA ST STE 100, MERIDIAN, ID 83642-7289
(208) 898-8999
(208) 898-8989
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1195
ID
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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