Individual
JOHNNY LEROY MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9408 NIGHT HARBOR DR SE, LELAND, NC 28451-9594
(910) 833-4113
Mailing address
9408 NIGHT HARBOR DR SE, LELAND, NC 28451-9594
(910) 833-4113
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2035
NC
Other
Enumeration date
12/27/2012
Last updated
12/27/2012
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