Provider Demographics
NPI:1497246235
Name:MANBY, MARIA (MS SLP/CCC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:MANBY
Suffix:
Gender:F
Credentials:MS SLP/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 BARTLETT DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-1716
Mailing Address - Country:US
Mailing Address - Phone:262-352-9926
Mailing Address - Fax:
Practice Address - Street 1:2660 BARTLETT DR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-1716
Practice Address - Country:US
Practice Address - Phone:262-352-9926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist