Provider Demographics
NPI:1205214921
Name:MAARANEN, ANNAMARI (PSYD)
Entity Type:Individual
Prefix:
First Name:ANNAMARI
Middle Name:
Last Name:MAARANEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ANNAMARI
Other - Middle Name:
Other - Last Name:MAARANEN-HINCKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:950 VOYAGER DR BLDG 147
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78236-5637
Mailing Address - Country:US
Mailing Address - Phone:303-523-2318
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX38277103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program