Manetta, Brea Ann
Manetta, Brea Ann is an sole proprietor health care provider with primary practice located at 19 Old Town Sq , Fort Collins CO 80524-2471. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Manetta, Brea Ann can be contacted via phone (970) 391-0629.Contact Information
Primary practice address
19 Old Town Sq
Fort Collins CO 80524-2471
Phone: (970) 391-0629
Fax: (970) 482-0251
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2568 | Colorado |
Profile Details
| NPI number | 1932243011 |
|---|---|
| LBN Legal business name | Manetta, Brea Ann |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 20th, 2007 |
| Last updated | Oct 23rd, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932243011 | NPPES |
| Colorado | Other | 018336 | VALUE OPTIONS |
| Colorado | Other | 2270399 | VALUE OPTIONS |
| Colorado | Other | MA658563 | VALUE OPTIONS |
| Colorado | MEDICAID | 01707353 | VALUE OPTIONS |
| Colorado | Other | 7079467 | VALUE OPTIONS |
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