Provider Demographics
NPI:1770397879
Name:MANACE, VENITE
Entity type:Individual
Prefix:
First Name:VENITE
Middle Name:
Last Name:MANACE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VENITE
Other - Middle Name:
Other - Last Name:CEARC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4407 W PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-2036
Mailing Address - Country:US
Mailing Address - Phone:623-934-9091
Mailing Address - Fax:
Practice Address - Street 1:4407 W PEORIA AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-2036
Practice Address - Country:US
Practice Address - Phone:623-934-9091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical