Provider Demographics
NPI:1992855027
Name:MANLEY, JAMES C (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:MANLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76-6300 MAHUAHUA PL
Mailing Address - Street 2:
Mailing Address - City:KAILUA-KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740
Mailing Address - Country:US
Mailing Address - Phone:808-326-7653
Mailing Address - Fax:808-329-0188
Practice Address - Street 1:76-6300 MAHUAHUA PL
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2224
Practice Address - Country:US
Practice Address - Phone:808-326-7653
Practice Address - Fax:808-329-0188
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI682103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic