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NPI Code Detail

MEDICARE: HANNAH MANYARA LGPC

MEDICARE: HANNAH MANYARA LGPC
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
1101YP2500XProfessional CounselorLGP9995MD

General Provider Information

NPI Number : 1285278143
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH MANYARA LGPC
Provider Business Mailing Address
First Line : 1231 SUMMERWOOD CT
Second Line :
City : ARNOLD
State : MD
Zip : 21012-1988
Country : US
Telephone Number : 515-520-0223
Fax Number :
Provider Business Practice Location Address
First Line : 1819 BAY RIDGE AVE STE 190
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21403-2834
Country : US
Telephone Number : 443-281-9430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2019
Last Update Date : 11/05/2019

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Directions to “ HANNAH MANYARA LGPC” Practice Location

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