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Contact Information

CHARLES MANDA, PHD
24 REVIS RD
WEST LIBERTY, KY41472-7818
 Phone: 502-436-3533
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pastoral

101YP1600X
Indicates primary specialty

NPI Profile & details for CHARLES MANDA · (Male)

NPI Number 1003481805
Status Active
Credentials PHD
Entity Individual
Enumeration date 05/24/2021
Last updated 06/05/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • KY License # 267057
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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