Provider Demographics
NPI:1346050846
Name:FLOYD, MANESA UNIQUE (AA)
Entity type:Individual
Prefix:
First Name:MANESA
Middle Name:UNIQUE
Last Name:FLOYD
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 E CAREY AVE TRLR 173
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-4422
Mailing Address - Country:US
Mailing Address - Phone:424-366-0159
Mailing Address - Fax:
Practice Address - Street 1:2295 RENAISSANCE DR STE D
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6758
Practice Address - Country:US
Practice Address - Phone:702-763-5379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician