Individual
TANJA MANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
12600 CREEKSIDE LN STE 7, FORT MYERS, FL 33919-3353
(239) 343-9220
(239) 343-4240
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9220
(239) 343-9231
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY7833
FL
103T00000X
Psychologist
PY7833
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105805000
—
FL
Enumeration date
11/03/2008
Last updated
02/27/2024
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