Doctor Name: | STEVEN B MANN |
NPI Number: | 1699743799 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 0480000217 |
Business Practice Address: | 3505 Richville Rd Ste B Manchester Center, VT - 052559812 |
Business Phone Number: | 8028654500 |
Business Fax Number: | 8028654800 |
Mailing Address: | 3505 Richville Rd, Ste B MANCHESTER CENTER |
State: | VT |
Postal Code: | 052559812 |
Phone Number: | 8028654500 |
Fax Number: | 8028654800 |
NPI Enumeration Date: | 03/14/2006 |
NPI Last Update Date: | 04/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 0480000217 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |