Individual
MARGARET MARY MANNIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
593 EDDY ST, POTTER BASEMENT, PROVIDENCE, RI 02903-4923
(401) 444-8368
(401) 444-2085
Mailing address
593 EDDY ST, APC 978, PROVIDENCE, RI 02903-4923
(401) 444-4318
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PS01196
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS01196
PROFESSIONAL LICENSE
RI
Enumeration date
09/03/2008
Last updated
08/20/2010
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