Provider Demographics
NPI:1902449689
Name:MANATEE ASSOCIATES OF COUNSELING & ASSESSMENT
Entity Type:Organization
Organization Name:MANATEE ASSOCIATES OF COUNSELING & ASSESSMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:SHALENE
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:941-479-7866
Mailing Address - Street 1:975 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-5044
Mailing Address - Country:US
Mailing Address - Phone:941-479-7866
Mailing Address - Fax:
Practice Address - Street 1:975 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-5044
Practice Address - Country:US
Practice Address - Phone:941-479-7866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health