Individual
DR. SAMANTHA MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
255 CANYON BLVD, SUITE 200, BOULDER, CO 80302-4979
(303) 474-4055
(720) 638-3699
Mailing address
255 CANYON BLVD, SUITE 200, BOULDER, CO 80302-4979
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PSY.0004481
CO
103TC0700X
Clinical Psychologist
Primary
PSY.0004481
CO
Other
Enumeration date
11/08/2016
Last updated
01/15/2018
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