Provider Demographics
NPI:1235499286
Name:MANNING, ALLEN BRUCE (PHD)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:BRUCE
Last Name:MANNING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7625 HIGHBRIDGE RD
Mailing Address - Street 2:APARTMENT B3
Mailing Address - City:MANLIUS
Mailing Address - State:NY
Mailing Address - Zip Code:13104-1627
Mailing Address - Country:US
Mailing Address - Phone:315-750-0135
Mailing Address - Fax:
Practice Address - Street 1:428 S MAIN ST
Practice Address - Street 2:SUITE 111
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-2828
Practice Address - Country:US
Practice Address - Phone:315-343-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health