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General NPI Number Information
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NPI Number | 1942806799
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Entity Type | Organization
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Legal Business Name | DAVE MANNING ENTERPRISES LLC
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Dates
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Enumeration Date | 12/08/2020
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 4311 CRYSTAL LAKE DRIVE # 203
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City | POMPANO BEACH
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State | FL
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Zip | 33064
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Country | US
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Telephone | 954-254-6389
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Fax |
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Provider Business Mailing Address
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Address Line | 3907 N FEDERAL HWY # 271
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City | POMPANO BEACH
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State | FL
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Zip | 33064-6042
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Country | US
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Telephone | 954-254-6389
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DAVID LIVINGSTON MANNING
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Credential | LMHC
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Telephone | 954-254-6389
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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 |
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License Number State |
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