Provider Demographics
NPI:1235524828
Name:MANN, JUSTINE HOLLY (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTINE
Middle Name:HOLLY
Last Name:MANN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1282 BOYLSTON ST UNIT 927
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4462
Mailing Address - Country:US
Mailing Address - Phone:513-996-4446
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST # 812
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-5600
Practice Address - Fax:617-726-7541
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2019-07-02
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Provider Licenses
StateLicense IDTaxonomies
PAMT2081142084P0800X
MA2794182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry