MEDICARE: DR. SHEILA MCMANUS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS015053	PA

General Provider Information

NPI Number	:	1114084043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHEILA MCMANUS PH.D.

Provider Business Mailing Address
First Line	:	30 WOODALE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19118-3430
Country	:	US
Telephone Number	:	215-260-2367
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 STENTON AVE
Second Line	:	SUITE 1-I
City	:	PHILADELPHIA
State	:	PA
Zip	:	19118-3231
Country	:	US
Telephone Number	:	215-260-2367
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	08/21/2023

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