MEDICARE: IRIS MANNING

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1679372635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRIS MANNING

Provider Business Mailing Address
First Line	:	741 WESTERN AVE APT B2
Second Line	:
City	:	NASHVILLE
State	:	NC
Zip	:	27856-1127
Country	:	US
Telephone Number	:	252-907-8950
Fax Number	:

Provider Business Practice Location Address
First Line	:	741 WESTERN AVE APT B2
Second Line	:
City	:	NASHVILLE
State	:	NC
Zip	:	27856-1127
Country	:	US
Telephone Number	:	252-907-8950
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2025
Last Update Date	:	03/12/2025

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Directions to “ IRIS MANNING ” Practice Location

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