Provider Demographics
NPI:1770814972
Name:PINZON NINO, MARIA INES
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:INES
Last Name:PINZON NINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 SOUTHAMPTON B
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-7806
Mailing Address - Country:US
Mailing Address - Phone:561-667-1134
Mailing Address - Fax:
Practice Address - Street 1:132 SOUTHAMPTON B
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-7806
Practice Address - Country:US
Practice Address - Phone:561-667-1134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 11552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health