Provider Demographics
NPI:1578967956
Name:MAIDA, MARY FRANCES (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:FRANCES
Last Name:MAIDA
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 1:2024 W HENRIETTA RD STE 6C
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1361
Mailing Address - Country:US
Mailing Address - Phone:585-709-3065
Mailing Address - Fax:
Practice Address - Street 1:2024 W HENRIETTA RD STE 6C
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1361
Practice Address - Country:US
Practice Address - Phone:585-709-3065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-14
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010048103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist