Individual
DR. JOHN FRANCIS FIDANZA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
1040MP
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2125958
—
LA
Enumeration date
06/14/2005
Last updated
07/21/2015
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