Individual
IRENE T MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5360 HOLIDAY TER, KALAMAZOO, MI 49009-2126
(269) 353-3063
(269) 353-3069
Mailing address
5360 HOLIDAY TER, KALAMAZOO, MI 49009-2126
(269) 353-3063
(269) 353-3069
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301007832
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098983
MANAGED HEALTH NETWORK
—
01
—
680C94696
BCBS OF MICHIGAN
MI
Enumeration date
07/15/2006
Last updated
07/08/2007
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