Provider Demographics
NPI:1740364868
Name:MANNING, AMY J (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:J
Last Name:MANNING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MALLARD DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-7609
Mailing Address - Country:US
Mailing Address - Phone:412-327-1456
Mailing Address - Fax:
Practice Address - Street 1:5035 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:EXPORT
Practice Address - State:PA
Practice Address - Zip Code:15632-9348
Practice Address - Country:US
Practice Address - Phone:724-733-3491
Practice Address - Fax:724-733-3498
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009149L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical