Provider Demographics
NPI:1275672990
Name:MANLEY, KAREN L (OTRL,CHT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:MANLEY
Suffix:
Gender:F
Credentials:OTRL,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1789 KIRBY PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3657
Mailing Address - Country:US
Mailing Address - Phone:901-759-1282
Mailing Address - Fax:
Practice Address - Street 1:1789 KIRBY PKWY STE 3
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38138-3657
Practice Address - Country:US
Practice Address - Phone:901-759-1282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03042225XH1200X
TNOT0000000437225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand