Provider Demographics
NPI:1831224906
Name:MANNIS, ROBERT FRANK (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FRANK
Last Name:MANNIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:235 WES PATRICK ST
Mailing Address - Street 2:ROBERT F. MANNIS PHD
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701
Mailing Address - Country:US
Mailing Address - Phone:301-662-4160
Mailing Address - Fax:301-620-4344
Practice Address - Street 1:235 WES PATRICK ST
Practice Address - Street 2:ROBERT F. MANNIS PHD
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701
Practice Address - Country:US
Practice Address - Phone:301-662-4160
Practice Address - Fax:301-620-4344
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02233103T00000X
MD2233103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
892RMedicare PIN