Individual
DR. MICHAEL JAY MANALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
45 SOUTH AVE SE, STE 100, MARIETTA, GA 30060-2539
(770) 423-7500
(678) 909-0294
Mailing address
45 SOUTH AVE SE, STE 100, MARIETTA, GA 30060-2539
(770) 423-7500
(678) 909-0294
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY003588
GA
Other
Enumeration date
10/03/2011
Last updated
09/12/2012
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