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General NPI Number Information
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NPI Number | 1831232180
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Entity Type | Organization
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Legal Business Name | MICHAEL MCMANUS ASSOCIATES PA
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 4507 FURLING LN SUITE 212
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City | DESTIN
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State | FL
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Zip | 32541-5328
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Country | US
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Telephone | 850-830-8340
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Fax | 850-837-0123
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Provider Business Mailing Address
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Address Line | PO BOX 2418
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-2418
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Country | US
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Telephone | 850-830-8340
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Fax | 850-837-0123
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Authorized Official
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Title or Position | PRES.
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Name | MICHAEL MCMANUS
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Credential | L.C.S.W.
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Telephone | 850-830-8340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SW1774
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License Number State | FL
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