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Mr. Theodis Roosevelt Manning, BSENGINEERING
Peer Specialist in Midwest City, Oklahoma
NPI 1225316706

Theodis Roosevelt Manning is a Peer Specialist based in Midwest City, OK. Theodis Roosevelt Manning practices in Midwest City, OK and has the professional credentials of BSENGINEERING. The NPI Number for Theodis Roosevelt Manning is 1225316706 and holds a License No. (Oklahoma).

The current practice location address for Theodis Roosevelt Manning is 8306 Ne 10Th St, Midwest City, OK and can be reached out via phone at 405-732-0573.

Location: 8306 Ne 10Th St, Midwest City, OK, 73110-7155
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225316706
Provider Name
Theodis Roosevelt Manning
Credential
BSENGINEERING
Provider Entity Type
Individual
Gender
Male
Address
8306 Ne 10Th St, Midwest City, OK, 73110-7155
Phone Number
405-732-0573
Fax Number
Provider Enumeration Date
08/01/2011
Last Update Date
04/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00000000000000000000 01 OK N/A
institution
Provider Business Practice Location Address Details
Address
8306 Ne 10Th St
City
Midwest City
State
Oklahoma
Zip
73110-7155
Phone Number
405-732-0573
Fax Number
person
Provider Business Mailing Address Details
Address
8306 Ne 10Th St
City
Midwest City
State
Oklahoma
Zip
73110-7155
Phone Number
405-732-0573
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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