Healthcare Provider Details

I. General information

NPI: 1619284809
Provider Name (Legal Business Name): PAULA MANNING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7402 WESTSHIRE DR STE 105
LANSING MI
48917-8687
US

IV. Provider business mailing address

7402 WESTSHIRE DR STE 105
LANSING MI
48917-8687
US

V. Phone/Fax

Practice location:
  • Phone: 517-853-6800
  • Fax: 517-853-6801
Mailing address:
  • Phone: 517-853-6800
  • Fax: 517-853-6801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201007550
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: