| Doctor Name: | MICHAEL J. MANZA |
| NPI Number: | 1023103066 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | R057841-1 |
| Business Practice Address: | 223 Main St Beacon, NY - 125082770 |
| Business Phone Number: | 8458384900 |
| Business Fax Number: | 8458384915 |
| Mailing Address: | 230 North Rd, POUGHKEEPSIE |
| State: | NY |
| Postal Code: | 126011328 |
| Phone Number: | 8458384900 |
| Fax Number: | 8458384915 |
| NPI Enumeration Date: | 10/04/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | R057841-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |