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Organization

MARC J MANN PHD

Active
Other names
MARC J MANN PHD, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
JUDITH R MANN MS (OFFICE MANAGER)
(860) 329-6356
Entity
Organization

Contact information

Practice address
42 MORNINGSIDE DR, WEATOGUE, CT 06089-7956
(860) 329-6357
(860) 606-9678
Mailing address
42 MORNINGSIDE DR, WEATOGUE, CT 06089-7956
(860) 329-6357
(860) 606-9678

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008032230
CT
01
2064455939
ANTHEM
CT
Enumeration date
08/12/2019
Last updated
07/29/2024
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