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General NPI Number Information
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NPI Number | 1649227703
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Entity Type | Organization
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Legal Business Name | DR. KENNETH J. MANGES & ASSOCIATES, INC.
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 810 SYCAMORE ST SUITE 100
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City | CINCINNATI
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State | OH
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Zip | 45202-2155
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Country | US
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Telephone | 513-784-1333
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Fax | 513-338-1920
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Provider Business Mailing Address
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Address Line | 810 SYCAMORE ST SUITE 100
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City | CINCINNATI
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State | OH
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Zip | 45202-2155
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Country | US
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Telephone | 513-784-1333
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Fax | 513-338-1920
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH J. MANGES
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Credential | PHD
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Telephone | 513-784-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3656
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License Number State | OH
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