Individual
KRISTY MANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33461 SE PEORIA RD, CORVALLIS, OR 97333-2521
(541) 753-1202
Mailing address
33461 SE PEORIA RD, CORVALLIS, OR 97333-2521
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
11111713-4102
UT
235Z00000X
Speech-Language Pathologist
Primary
14066
OR
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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