Healthcare Provider Details

I. General information

NPI: 1417336017
Provider Name (Legal Business Name): MANA CARTER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MANA ALI PHD

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 10/24/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NATIONAL REHABILITATION HOSPITAL 102 IRVING STREET NW
WASHINGTON DC
20001
US

IV. Provider business mailing address

5601 LOCH RAVEN BLVD STE 406 JOHNS HOPKINS SOM DEPT OF PHYSICAL MED AND REHAB
BALTIMORE MD
21239
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-1120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number390200000X
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: