Provider Demographics
NPI:1063132348
Name:MANWARING, MONA (QMHA-R)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:MANWARING
Suffix:
Gender:F
Credentials:QMHA-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 NE 13TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97367-3524
Mailing Address - Country:US
Mailing Address - Phone:541-992-1897
Mailing Address - Fax:
Practice Address - Street 1:351 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-4963
Practice Address - Country:US
Practice Address - Phone:541-264-7067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health