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1790184638
MICHAEL FANNING
PALESTINE, TX
NPI
1790184638
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: TX 38300)
Additional Taxonomies
172A00000X Driver
Enumeration Date
2014-08-15
Last Update Date
2020-03-27
Business Address
Dr. MICHAEL FANNING
210 W OAK ST
PALESTINE, TX 75801-2710
Phone number: 404-734-6757
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Mailing Address
Dr. MICHAEL FANNING
9725 DECATUR DR
INDIANAPOLIS, IN 46256-9656
Phone number: 312-656-5489
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