Provider Demographics
NPI:1285278143
Name:MANYARA, HANNAH (LGPC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:MANYARA
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:GEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1231 SUMMERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-1988
Mailing Address - Country:US
Mailing Address - Phone:515-520-0223
Mailing Address - Fax:
Practice Address - Street 1:1819 BAY RIDGE AVE STE 190
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-2834
Practice Address - Country:US
Practice Address - Phone:443-281-9430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9995101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional