Individual
GLORIA POLK MANNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1604 ROANOKE BLVD, SALEM, VA 24153-6420
(540) 375-7620
(540) 375-7621
Mailing address
1604 ROANOKE BLVD, SALEM, VA 24153-6420
(540) 375-7620
(540) 375-7621
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001947
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008946086
—
VA
Enumeration date
07/14/2006
Last updated
06/24/2008
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