Provider Demographics
NPI:1659637114
Name:MANES, ROSEMARIE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARIE
Middle Name:
Last Name:MANES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BITTLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-9490
Mailing Address - Country:US
Mailing Address - Phone:215-332-2162
Mailing Address - Fax:
Practice Address - Street 1:146 LAKEVIEW DR S
Practice Address - Street 2:SUITE 300
Practice Address - City:GIBBSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08026-1018
Practice Address - Country:US
Practice Address - Phone:215-332-2162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37F100160900106H00000X
PAMF000025106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist