Healthcare Provider Details

I. General information

NPI: 1891925228
Provider Name (Legal Business Name): RACHEL MANN-ROSAN, PH.D, PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MAPLE DELL SUITE 3
SARATOGA SPRINGS NY
12866-2951
US

IV. Provider business mailing address

461 GRAND AVE
SARATOGA SPRINGS NY
12866-6109
US

V. Phone/Fax

Practice location:
  • Phone: 518-926-0037
  • Fax:
Mailing address:
  • Phone: 518-926-0037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number016353
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number016353
License Number StateNY

VIII. Authorized Official

Name: DR. RACHEL MANN-ROSAN
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 518-926-0037