Individual
DR. MANUEL ALEXANDER MANRIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., L.P.
Contact information
Practice address
22967 OUTER DR, DEARBORN, MI 48124-4248
(313) 561-9064
(313) 563-4480
Mailing address
22967 OUTER DR, DEARBORN, MI 48124-4248
(313) 561-9064
(313) 563-4480
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301008353
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070564
VALUE OPTIONS M-CARE
MI
01
—
5552704
AETNA
MI
01
—
680H248190
BLUE CROSS BLUE SHIELD
MI
01
—
DR822439
MCDR
MA
Enumeration date
01/26/2007
Last updated
06/10/2024
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