Individual
LAURA MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
593 NE AZURE DR STE 4, BEND, OR 97701-4883
(541) 306-3483
Mailing address
PO BOX 1432, BEND, OR 97709-1432
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
9999999999
OR
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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