Provider Demographics
NPI:1740717032
Name:FINA, THAIMI (MSED, LMHC)
Entity type:Individual
Prefix:
First Name:THAIMI
Middle Name:
Last Name:FINA
Suffix:
Gender:F
Credentials:MSED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7850 CAMINO REAL APT 404
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6806
Mailing Address - Country:US
Mailing Address - Phone:305-773-8469
Mailing Address - Fax:
Practice Address - Street 1:4601 PONCE DE LEON BLVD STE 260
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2110
Practice Address - Country:US
Practice Address - Phone:305-501-2643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13099101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health