Provider Demographics
NPI:1053894808
Name:MANLEY, NANA KAY
Entity type:Individual
Prefix:
First Name:NANA
Middle Name:KAY
Last Name:MANLEY
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 1:19580 VICTORIAN DR UNIT 208
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3895
Mailing Address - Country:US
Mailing Address - Phone:704-724-5942
Mailing Address - Fax:
Practice Address - Street 1:19751 E MAINSTREET STE 235
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7405
Practice Address - Country:US
Practice Address - Phone:704-724-5942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-07
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor