Provider Demographics
NPI:1295317675
Name:MANNING, JOANNE (LMFT)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:MANNING
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BLUE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-3366
Mailing Address - Country:US
Mailing Address - Phone:702-460-3799
Mailing Address - Fax:
Practice Address - Street 1:29 BLUE VALLEY DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-3366
Practice Address - Country:US
Practice Address - Phone:702-460-3799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-25
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2919101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health