Provider Demographics
NPI:1619170073
Name:MANN, AMY L (MSED)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:MANN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:L
Other - Last Name:LAFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 LEO MOSS DR
Mailing Address - Street 2:SUITE 4308
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1156
Mailing Address - Country:US
Mailing Address - Phone:716-373-8040
Mailing Address - Fax:716-701-3729
Practice Address - Street 1:1 LEO MOSS DR
Practice Address - Street 2:SUITE 4308
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1156
Practice Address - Country:US
Practice Address - Phone:716-373-8040
Practice Address - Fax:716-701-3729
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health