Healthcare Provider Details

I. General information

NPI: 1922940378
Provider Name (Legal Business Name): VIOLET KIM MANNING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36880 WOODWARD AVE STE 107
BLOOMFIELD HILLS MI
48304-0920
US

IV. Provider business mailing address

36880 WOODWARD AVE STE 107
BLOOMFIELD HILLS MI
48304-0920
US

V. Phone/Fax

Practice location:
  • Phone: 248-433-3075
  • Fax: 248-433-3078
Mailing address:
  • Phone: 248-433-3075
  • Fax: 248-433-3078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: