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Individual

MISS REENA ANNETTA MANKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CACII

Contact information

Practice address
888 GARDEN OF THE GODS, 150, COLORADO SPRINGS, CO 80907
(719) 219-0062
Mailing address
888 GARDEN OF THE GODS RD STE 150, COLORADO SPRINGS, CO 80907-9435

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACB.0007577
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ACB.0007577
COLORADO DEPARTMENT OF REGULATORY AGENCIES
CO
Enumeration date
07/17/2017
Last updated
03/17/2018
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