Individual
SHANNON MANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3901 S ATHERTON ST STE 5, STATE COLLEGE, PA 16801-8324
(814) 466-7921
(814) 466-6570
Mailing address
3901 S ATHERTON ST STE 5, STATE COLLEGE, PA 16801-8324
(814) 466-7921
(814) 466-6570
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS019573
PA
103TC2200X
Clinical Child & Adolescent Psychologist
PS019573
PA
Other
Enumeration date
12/07/2017
Last updated
06/15/2022
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