Provider Demographics
NPI:1003826074
Name:MAIER, DONNA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:MAIER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 REYNARD AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-5050
Mailing Address - Country:US
Mailing Address - Phone:513-739-8705
Mailing Address - Fax:937-848-2080
Practice Address - Street 1:743 REYNARD AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5050
Practice Address - Country:US
Practice Address - Phone:513-739-8705
Practice Address - Fax:937-848-2080
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4939103TC0700X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
510453349OtherPACIFIC HEALTH CARE SYSTE
510453349OtherCORE SOURCE
0005681688OtherAETNA
510453349OtherUNITED MEDICAL RESOURCES
510453349OtherCORPHEALTH
000000285280OtherANTHEM
510453349OtherVALUE OPTIONS
6121348OtherUNITED BEHAVIORAL HEALTH
0117920OtherTRICARE
OH0117920Medicaid
242783000OtherMAYELLAN
242783000OtherMAYELLAN
0005681688OtherAETNA
510453349OtherCORE SOURCE