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NPI Code Detail

MEDICARE: DR. LEANNA ELAINE MANUEL PSY.D.

MEDICARE: DR. LEANNA ELAINE MANUEL PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist5340OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1311588267OTHEROHTRICARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003816091
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEANNA ELAINE MANUEL PSY.D.
Provider Business Mailing Address
First Line : 1321 RESEARCH PARK DR
Second Line : SUITE 200
City : BEAVERCREEK
State : OH
Zip : 45432-2851
Country : US
Telephone Number : 937-431-3870
Fax Number : 937-431-3871
Provider Business Practice Location Address
First Line : 1321 RESEARCH PARK DR
Second Line : SUITE 200
City : BEAVERCREEK
State : OH
Zip : 45432-2851
Country : US
Telephone Number : 937-431-3870
Fax Number : 937-431-3871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2005
Last Update Date : 02/10/2016

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