=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548146798
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANA COLLEEN MANNING LLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2025
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1603 E 9 MILE RD
-----------------------------------------------------
City | FERNDALE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48220-2065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-514-4955
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 251 LAKESIDE DRIVE
-----------------------------------------------------
City | HARROW
-----------------------------------------------------
State | ONTARIO
-----------------------------------------------------
Zip | N0R1G0
-----------------------------------------------------
Country | CA
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 6361008220
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------