Individual
MS. KIM SUZANNE MANLANGIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5803
(757) 953-6091
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5861
(757) 953-6091
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C005500
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14372
BCBS
NC
05
—
6106521
—
NC
Enumeration date
12/26/2006
Last updated
09/23/2019
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