Provider Demographics
NPI:1891925228
Name:RACHEL MANN-ROSAN, PH.D, PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:RACHEL MANN-ROSAN, PH.D, PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANN-ROSAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:518-926-0037
Mailing Address - Street 1:461 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-6109
Mailing Address - Country:US
Mailing Address - Phone:518-926-0037
Mailing Address - Fax:
Practice Address - Street 1:15 MAPLE DELL
Practice Address - Street 2:SUITE 3
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2951
Practice Address - Country:US
Practice Address - Phone:518-926-0037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016353103TC0700X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty