Healthcare Provider Details

I. General information

NPI: 1295675866
Provider Name (Legal Business Name): DELIAH ELAINE MANUEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 FORT ROOTS DR RM 209
NORTH LITTLE ROCK AR
72114-1709
US

IV. Provider business mailing address

2200 FORT ROOTS DR RM 209
NORTH LITTLE ROCK AR
72114-1709
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-3453
  • Fax: 501-257-1671
Mailing address:
  • Phone: 501-257-3453
  • Fax: 501-257-1671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: