Provider Demographics
NPI:1518581388
Name:NAMIN, FARNAZ (PHD)
Entity type:Individual
Prefix:
First Name:FARNAZ
Middle Name:
Last Name:NAMIN
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 1:8815 CONROY WINDERMERE RD # 179
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3129
Mailing Address - Country:US
Mailing Address - Phone:407-340-1228
Mailing Address - Fax:
Practice Address - Street 1:9100 CONROY WINDERMERE RD # 500
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-8431
Practice Address - Country:US
Practice Address - Phone:407-340-1228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional