Provider Demographics
NPI:1497804264
Name:MCMANUS, DEANNA (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-2175
Mailing Address - Country:US
Mailing Address - Phone:607-739-0583
Mailing Address - Fax:607-739-1364
Practice Address - Street 1:133 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-2175
Practice Address - Country:US
Practice Address - Phone:607-739-0583
Practice Address - Fax:607-739-1364
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009421-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist