Individual
MIRANDA MANIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
9111 BROADWAY STE JJ, MERRILLVILLE, IN 46410-7002
(219) 216-3605
Mailing address
9111 BROADWAY STE JJ, MERRILLVILLE, IN 46410-7002
(219) 216-3605
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34012084A
IN
Other
Enumeration date
08/02/2023
Last updated
07/15/2025
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