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NPI Code Detail

MEDICARE: AMANDA LYNN MANZER

MEDICARE: AMANDA LYNN MANZER
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
1101YP2500XProfessional CounselorLPC-18578AZ

General Provider Information

NPI Number : 1760021570
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA LYNN MANZER
Provider Business Mailing Address
First Line : 504 W 29TH ST
Second Line :
City : TUCSON
State : AZ
Zip : 85713-3353
Country : US
Telephone Number : 520-838-5600
Fax Number :
Provider Business Practice Location Address
First Line : 502 W 29TH ST
Second Line :
City : TUCSON
State : AZ
Zip : 85713-3394
Country : US
Telephone Number : 520-838-3983
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2019
Last Update Date : 12/26/2019

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Directions to “ AMANDA LYNN MANZER ” Practice Location

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