Provider Demographics
NPI:1780326942
Name:MANILAY, JUDY
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:MANILAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 141806
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99514-1806
Mailing Address - Country:US
Mailing Address - Phone:907-903-8718
Mailing Address - Fax:907-562-0178
Practice Address - Street 1:4110 SPENARD RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-2903
Practice Address - Country:US
Practice Address - Phone:907-563-4545
Practice Address - Fax:907-562-0178
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health