Individual
MS. GLENDA G MANVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
409 SE DOUGLAS ST, LEES SUMMIT, MO 64063
(816) 524-5818
(816) 524-5819
Mailing address
409 SE DOUGLAS ST, LEES SUMMIT, MO 64063
(816) 524-5818
(816) 524-5819
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PYD1612
MO
Other
Enumeration date
07/09/2006
Last updated
07/08/2007
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