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General NPI Number Information
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NPI Number | 1720663347
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Entity Type | Organization
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Legal Business Name | MANLEY MENTAL HEALTH LLC
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 03/15/2021
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Provider Practice Location Address
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Address Line | 1415 BLANDING ST STE 4
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City | COLUMBIA
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State | SC
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Zip | 29201-2922
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Country | US
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Telephone | 80-377-9750
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Fax |
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Provider Business Mailing Address
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Address Line | 549 BYARS RD
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City | LAURENS
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State | SC
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Zip | 29360-5124
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Country | US
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Telephone | 803-606-4172
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | AMBER MANLEY
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Credential | APRN
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Telephone | 803-606-4172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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