Individual
DR. BRUCE K. MANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8350 N SAINT CLAIR AVE, SUITE 250, KANSAS CITY, MO 64151-5100
(816) 223-6128
Mailing address
5411 NW EDGEWOOD TRL, KANSAS CITY, MO 64151-3393
(816) 223-6128
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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