Individual
DR. BREA ANN MANETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
19 OLD TOWN SQ, FORT COLLINS, CO 80524-2471
(970) 391-0629
(970) 482-0251
Mailing address
19 OLD TOWN SQ, FORT COLLINS, CO 80524-2471
(970) 391-0629
(970) 482-0251
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2568
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01707353
—
CO
01
—
018336
VALUE OPTIONS
CO
01
—
2270399
CIGNA
CO
01
—
7079467
AETNA
CO
01
—
MA658563
BLUE CROSS
CO
Enumeration date
02/20/2007
Last updated
10/23/2008
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