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General NPI Number Information
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NPI Number | 1912212440
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Entity Type | Individual
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Provider Name | DEBORAH JILL MANN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 111 ATLANTIC AVE
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City | LYNBROOK
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State | NY
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Zip | 11563-3476
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Country | US
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Telephone | 516-612-5436
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Fax |
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Provider Business Mailing Address
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Address Line | 111 ATLANTIC AVE
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City | LYNBROOK
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State | NY
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Zip | 11563-3476
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Country | US
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Telephone | 516-612-5463
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 020535
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 020535
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License Number State | NY
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