MEDICARE: DR. SANDRA MANN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	0003989	CO

General Provider Information

NPI Number	:	1508014267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA MANN PSYD

Provider Business Mailing Address
First Line	:	1355 S COLORADO BLVD STE 100
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3310
Country	:	US
Telephone Number	:	303-756-9052
Fax Number	:

Provider Business Practice Location Address
First Line	:	1355 S COLORADO BLVD STE 100
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-3310
Country	:	US
Telephone Number	:	303-756-9052
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2008
Last Update Date	:	04/05/2024

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