Provider Demographics
NPI:1528578259
Name:MANALIGOD, ENROS MISOLA (MA, IMFT)
Entity Type:Individual
Prefix:
First Name:ENROS
Middle Name:MISOLA
Last Name:MANALIGOD
Suffix:
Gender:F
Credentials:MA, IMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 YESTERDAY DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5853
Mailing Address - Country:US
Mailing Address - Phone:716-901-4082
Mailing Address - Fax:
Practice Address - Street 1:87 YESTERDAY DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5853
Practice Address - Country:US
Practice Address - Phone:716-901-4082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT100.0134255TELE106H00000X
COMFT.0002461106H00000X
IDMBTMFT-9869106H00000X
OHM.1700030106H00000X
FLTPMF1072106H00000X
OHF.2000152106H00000X
NV3209-R106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist