Individual
MARY BETH MANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
238 JEWETT AVE, BRIDGEPORT, CT 06606-2845
(203) 372-4301
(203) 373-0835
Mailing address
238 JEWETT AVE, BRIDGEPORT, CT 06606-2845
(203) 372-4301
(203) 373-0835
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004040655
—
CT
Enumeration date
04/03/2009
Last updated
04/03/2009
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