Doctor Name: | MRS. KRISTA MARIE-MEREZKO MANTON |
NPI Number: | 1881773083 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LPC #894 |
Business Practice Address: | 1050 N 3rd St Suite B-1 Laramie, WY - 820722544 |
Business Phone Number: | 3077424769 |
Business Fax Number: | 3077426702 |
Mailing Address: | 1050 N 3rd St, Suite B-1 LARAMIE |
State: | WY |
Postal Code: | 820722544 |
Phone Number: | 3077424769 |
Fax Number: | 3077426702 |
NPI Enumeration Date: | 11/06/2006 |
NPI Last Update Date: | 10/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPC #894 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |