Provider Demographics
NPI:1013539279
Name:MANNING, PAULA MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:MICHELLE
Last Name:MANNING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 HIRTH DR
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-3672
Mailing Address - Country:US
Mailing Address - Phone:817-235-0642
Mailing Address - Fax:
Practice Address - Street 1:156 HIRTH DR
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-3672
Practice Address - Country:US
Practice Address - Phone:817-235-0642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
73742101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional