Individual
MRS. KIRA M MANTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
512 HOUSTON ST, STAUNTON, VA 24401-3525
(888) 365-6271
Mailing address
115 SUMMIT ST, SPENCER, WV 25276-1140
(757) 692-8081
(304) 927-8198
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009469
VA
1041C0700X
Clinical Social Worker
DP00945238
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0904009469
LICENSE
VA
Enumeration date
04/02/2009
Last updated
08/29/2019
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