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Mr. Bruce Manise, EDM,MA
Professional Counselor in Vienna, Virginia
NPI 1932644671

Bruce Manise is a Professional Counselor based in Vienna, VA and is specialized in Professional. Bruce Manise practices in Vienna, VA and has the professional credentials of EDM,MA. The NPI Number for Bruce Manise is 1932644671 and holds a License No. 0701003313 (Virginia).

The current practice location address for Bruce Manise is 131 Park St Ne # 8, Vienna, VA and can be reached out via phone at 703-582-0023.

Location: 131 Park St Ne # 8, Vienna, VA, 22182-5102
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1932644671
Provider Name
Bruce Manise
Credential
EDM,MA
Provider Entity Type
Individual
Gender
Male
Address
131 Park St Ne # 8, Vienna, VA, 22182-5102
Phone Number
703-582-0023
Fax Number
Provider Enumeration Date
01/05/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0701003313 01 VA LICENSED PROFESSIONAL COUNSELOR
institution
Provider Business Practice Location Address Details
Address
131 Park St Ne # 8
City
Vienna
State
Virginia
Zip
22180-4641
Phone Number
703-582-0023
Fax Number
person
Provider Business Mailing Address Details
Address
131 Park St Ne # 8
City
Vienna
State
Virginia
Zip
22180-4641
Phone Number
703-582-0023
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
0701003313 (Virginia)
Definition
Definition to come...
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