Basic Information
| Provider Information | |||||||||
| NPI: | 1215300702 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MANNING-SMITH | ||||||||
| FirstName: | YVONNE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MHP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6619 RALEIGH DR | ||||||||
| Address2: | |||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706077651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372631247 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1333 COMMON STREET | ||||||||
| Address2: | |||||||||
| City: | LAKE CHARLES | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374374014 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2015 | ||||||||
| LastUpdateDate: | 11/05/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 101YM0800X | LA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.