Roland, Mark Manfred
Roland, Mark Manfred is an sole proprietor health care provider with primary practice located at 21 Trammel St. Sw Psychological Consultants Of Marietta Pc, Marietta GA 30064-3249. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Roland, Mark Manfred can be contacted via phone (770) 420-9448.Contact Information
Primary practice address
21 Trammel St. Sw Psychological Consultants Of Marietta Pc
Marietta GA 30064-3249
Phone: (770) 420-9448
Fax: (770) 420-9441
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1872 | Georgia |
Profile Details
| NPI number | 1104960715 |
|---|---|
| LBN Legal business name | Roland, Mark Manfred |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 16th, 2007 |
| Last updated | Sep 16th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104960715 | NPPES |
| Georgia | MEDICAID | 00661691A |
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