Most Relevant Information
Provider Data
| NPI Number: | 1003393869 |
| Provider Name: | VIVIAN MARANA-MANCHESS BCBA, LBA, CASAC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/24/2018 |
| Last Updated: | 07/24/2018 |
Provider Practice Location
4732 41ST ST
SUNNYSIDE
NY
111043646
Practice Location Phone/Fax
| Phone: | 3476350728 |
| Fax: |
Provider Mailing Location
4732 41ST ST
SUNNYSIDE
NY
111043646
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |