Individual
MRS. KIMBERLY D MANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
304 W FISHER AVE, GREENSBORO, NC 27401-2044
(336) 207-8603
Mailing address
304 W FISHER AVE, GREENSBORO, NC 27401-2044
(336) 207-8603
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A7659
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A7659
STATE LICENSE NUMBER
NC
Enumeration date
08/26/2013
Last updated
08/26/2013
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