| Ingrid Manfredo | |
|
178 Thomas Johnson Dr Suite 205 Frederick MD 21702-4386 | |
| (301) 639-1545 | |
| Not Available |
| Full Name | Ingrid Manfredo |
|---|---|
| Speciality | Social Worker |
| Location | 178 Thomas Johnson Dr, Frederick, Maryland |
| Authorized Official Name and Position | Ingrid Manfredo (OWNER) |
| Authorized Official Contact | 3016391545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingrid Manfredo Po Box 1473 Frederick MD 21702-0473 Ph: (301) 639-1545 | Ingrid Manfredo 178 Thomas Johnson Dr Suite 205 Frederick MD 21702-4386 Ph: (301) 639-1545 |
| NPI Number | 1720466725 |
|---|---|
| Provider Enumeration Date | 05/11/2015 |
| Last Update Date | 05/11/2015 |
| Medicare PECOS PAC ID | 3274854666 |
|---|---|
| Medicare Enrollment ID | O20150611000072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720466725 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ingrid J Manfredo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235572835 PECOS PAC ID: 2668610759 Enrollment ID: I20130531000195 |
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