Provider Demographics
NPI:1437312097
Name:MANESS, PAULA JEAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:JEAN
Last Name:MANESS
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6223 HIGHWAY 90 STE 282
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-1705
Mailing Address - Country:US
Mailing Address - Phone:866-441-6200
Mailing Address - Fax:
Practice Address - Street 1:101 RIVERFRONT BLVD STE 710
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8812
Practice Address - Country:US
Practice Address - Phone:941-776-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23787103T00000X, 103TC0700X
FLPY64668103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical