Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1003059486 |
---|---|
Provider Name | Dr. Michael Joseph Mannia |
First Address | Bakersfield, CA 93309-1562 |
Second Address | Bakersfield, CA 93309-1562 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2009 |
Last Update Date | 14/04/2009 |