Individual
SHAWNYA MARIE MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
2945 MCMILLAN AVE, SAN LUIS OBISPO, CA 93401-6766
(805) 439-9890
Mailing address
2945 MCMILLAN AVE, SAN LUIS OBISPO, CA 93401-6766
(805) 439-9890
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
34044
CA
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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