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NPI Code Detail

MEDICARE: PATRICIA MANNING BA QMHP

MEDICARE: PATRICIA MANNING BA QMHP
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1710137989
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA MANNING BA QMHP
Provider Business Mailing Address
First Line : 3908 BRONCO BEND LOOP
Second Line :
City : AUSTIN
State : TX
Zip : 78744-1753
Country : US
Telephone Number : 512-779-5326
Fax Number :
Provider Business Practice Location Address
First Line : 1524 S IH 35 STE 210
Second Line :
City : AUSTIN
State : TX
Zip : 78704-2603
Country : US
Telephone Number : 512-343-8620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2008
Last Update Date : 09/24/2008

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Directions to “ PATRICIA MANNING BA QMHP” Practice Location

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