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General NPI Number Information
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NPI Number | 1306977426
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Entity Type | Individual
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Provider Name | BRUCE K. MANLEY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 04/16/2013
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Provider Practice Location Address
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Address Line | 8350 N SAINT CLAIR AVE SUITE 250
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City | KANSAS CITY
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State | MO
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Zip | 64151-5100
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Country | US
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Telephone | 816-223-6128
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Fax |
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Provider Business Mailing Address
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Address Line | 5411 NW EDGEWOOD TRL
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City | KANSAS CITY
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State | MO
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Zip | 64151-3393
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Country | US
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Telephone | 816-223-6128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2001003634
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP-0999
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 2001003634
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License Number State | MO
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