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Individual

DR. ROBERT GRENFELL MANKOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
4000 BLUE RIDGE RD, SUITE 200, RALEIGH, NC 27612-4650
(919) 782-4981
(919) 782-2474
Mailing address
4029 BALSAM DR, RALEIGH, NC 27612-3605
(919) 781-5199

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1963
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6000666
NC
Enumeration date
02/22/2007
Last updated
07/08/2007
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