Provider Demographics
NPI:1902196462
Name:NAINEE, MARIA BERARDI (LMT MMP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:BERARDI
Last Name:NAINEE
Suffix:
Gender:F
Credentials:LMT MMP
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:BERARDI
Other - Last Name:LEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT MMP
Mailing Address - Street 1:422 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-2726
Mailing Address - Country:US
Mailing Address - Phone:419-625-0707
Mailing Address - Fax:419-501-0217
Practice Address - Street 1:422 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-2726
Practice Address - Country:US
Practice Address - Phone:419-625-0707
Practice Address - Fax:419-501-0217
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7082225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist