Individual
ELYSE MARIE MANTERIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LP
Contact information
Practice address
582 BEAUPREZ AVE, LAFAYETTE, CO 80026-3455
(303) 919-8459
Mailing address
582 BEAUPREZ AVE, LAFAYETTE, CO 80026-3455
(303) 919-8459
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY.0004261
CO
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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