Provider Demographics
NPI:1992698377
Name:MANUEL, CARLA T
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:T
Last Name:MANUEL
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 11TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3285
Mailing Address - Country:US
Mailing Address - Phone:561-234-5438
Mailing Address - Fax:
Practice Address - Street 1:9599 SAVONA WINDS DR
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-9754
Practice Address - Country:US
Practice Address - Phone:561-234-5438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician