Individual
DR. MICHAEL FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 W OAK ST, PALESTINE, TX 75801-2710
(404) 734-6757
(877) 737-0499
Mailing address
9725 DECATUR DR, INDIANAPOLIS, IN 46256-9656
(312) 656-5489
(877) 737-0499
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
38300
TX
172A00000X
Driver
—
—
Other
Enumeration date
08/15/2014
Last updated
03/27/2020
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