Provider Demographics
NPI:1780469072
Name:MANLEY, DEVAN MICHAEL
Entity type:Individual
Prefix:
First Name:DEVAN
Middle Name:MICHAEL
Last Name:MANLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MIA
Other - Middle Name:
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 NEW STATESIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-1213
Mailing Address - Country:US
Mailing Address - Phone:833-800-1505
Mailing Address - Fax:
Practice Address - Street 1:104 NEW STATESIDE DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-1213
Practice Address - Country:US
Practice Address - Phone:833-800-1505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical