Provider Demographics
NPI:1437131935
Name:SIU, MANWAH MAUREEN (MS, LCPC, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:MANWAH
Middle Name:MAUREEN
Last Name:SIU
Suffix:
Gender:F
Credentials:MS, LCPC, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 49198
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78765-9198
Mailing Address - Country:US
Mailing Address - Phone:512-203-7601
Mailing Address - Fax:512-255-6383
Practice Address - Street 1:604B W 9TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2212
Practice Address - Country:US
Practice Address - Phone:512-203-7601
Practice Address - Fax:512-255-6383
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17629101YP2500X
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional