Individual
DR. BRUCE K. MANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2001003634
MO
103TC0700X
Clinical Psychologist
LP-0999
KS
103TH0100X
Health Service Psychologist
2001003634
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27031028
BLUE CROSS NON-PROVIDER #
MO
Enumeration date
03/08/2007
Last updated
04/16/2013
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