Provider Demographics
NPI:1144897554
Name:MANN, SHAYLA
Entity type:Individual
Prefix:
First Name:SHAYLA
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 YEARLING LN APT 1
Mailing Address - Street 2:
Mailing Address - City:BLOWING ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28605-7237
Mailing Address - Country:US
Mailing Address - Phone:252-702-1137
Mailing Address - Fax:
Practice Address - Street 1:210 YEARLING LN APT 1
Practice Address - Street 2:
Practice Address - City:BLOWING ROCK
Practice Address - State:NC
Practice Address - Zip Code:28605-7237
Practice Address - Country:US
Practice Address - Phone:252-702-1137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-06
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health