Provider Demographics
NPI:1477665073
Name:FIMIANI, MARIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:FIMIANI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8303 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8356
Mailing Address - Country:US
Mailing Address - Phone:810-606-1041
Mailing Address - Fax:
Practice Address - Street 1:1460 N CENTER RD
Practice Address - Street 2:BEHAVIORAL SCIENCE DEPARTMENT
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1429
Practice Address - Country:US
Practice Address - Phone:810-715-4322
Practice Address - Fax:810-715-4371
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012065103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical