Individual
MATTHEW MANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA. LAC. LPC-MH.
Contact information
Practice address
906 W 5TH ST, CANTON, SD 57013-1532
(715) 572-5476
Mailing address
906 W 5TH ST, CANTON, SD 57013-1532
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19091832
SD
101YM0800X
Mental Health Counselor
Primary
LPC-MH30723
SD
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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