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NPI Code Detail

MEDICARE: MERRIDITH MANNING LMFT

MEDICARE: MERRIDITH MANNING LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor6546ID
2106H00000XMarriage & Family Therapist98777CA
3106H00000XMarriage & Family Therapist6546ID

General Provider Information

NPI Number : 1235521253
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERRIDITH MANNING LMFT
Provider Business Mailing Address
First Line : 961 E ODYSSEY ST
Second Line :
City : KUNA
State : ID
Zip : 83634-5618
Country : US
Telephone Number : 208-576-9239
Fax Number :
Provider Business Practice Location Address
First Line : 6003 W OVERLAND RD STE 101
Second Line :
City : BOISE
State : ID
Zip : 83709-3075
Country : US
Telephone Number : 208-917-2543
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2015
Last Update Date : 08/21/2024

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Directions to “ MERRIDITH MANNING LMFT” Practice Location

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