Organization
MICHELLE M. MANASSERI PSYD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MANASSERI PSY.D. (PSYCHOLOGIST)
(302) 478-1578
Entity
Organization
Contact information
Practice address
910 S CHAPEL ST, STE 201, NEWARK, DE 19713-3467
(302) 224-1400
Mailing address
1125 CRESTOVER RD, WILMINGTON, DE 19803-3308
(302) 385-6228
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
B1-0001005
DE
103G00000X
Clinical Neuropsychologist
PS017616
PA
103TC0700X
Clinical Psychologist
Primary
B1-0001005
DE
103TC0700X
Clinical Psychologist
PS017616
PA
103TR0400X
Rehabilitation Psychologist
B1-0001005
DE
103TR0400X
Rehabilitation Psychologist
PS017616
PA
Other
Enumeration date
10/20/2014
Last updated
02/13/2015
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