Individual
AMANDA RUTH MAHNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
625 MOUNT AUBURN ST STE 205A, CAMBRIDGE, MA 02138-4530
(857) 760-0210
Mailing address
11 KENWOOD ST, PORTLAND, ME 04102-2704
(202) 680-0306
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11733
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2021
Last updated
03/15/2022
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