Provider Information for 1538757620
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Mrs. NANCY JO MANLY LPC
Sex: Female
NPI: 1538757620
Last Updated: 2021-01-05
Certification Date: 2021-01-05
Certification Date: 2021-01-05
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1538757620 | ||||||||||||||
| Enumeration Date | 2021-01-05 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 2185 COLDSTONE WAY COLORADO SPRINGS, CO 80921-4011 United States Phone: 719-237-2102 | Fax: | ||||||||||||||
| Primary Practice Address | 2185 COLDSTONE WAY COLORADO SPRINGS, CO 80921-4011 United States Phone: 719-237-2102 | Fax: | ||||||||||||||
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