Theodis Manning

NPI #1194071357 in Midwest City, Oklahoma

Provider Information

NPI Number: 1194071357
Entity Type: Individual
Name: Theodis Manning
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Jul 25, 2012
Last Updated: Jul 25, 2012

Practice Location

Address: 8320 NE 10TH ST
City: Midwest City
State: Oklahoma
ZIP Code: 73110-7155
Phone: (405) 761-3041

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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