Provider Demographics
NPI:1194494583
Name:FARD-AGHAIE, PARINAZ (RMHI - IMH)
Entity type:Individual
Prefix:
First Name:PARINAZ
Middle Name:
Last Name:FARD-AGHAIE
Suffix:
Gender:F
Credentials:RMHI - IMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 ENGLENOOK DR
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-1803
Mailing Address - Country:US
Mailing Address - Phone:407-732-7266
Mailing Address - Fax:
Practice Address - Street 1:352 ENGLENOOK DR
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-1803
Practice Address - Country:US
Practice Address - Phone:407-732-7266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH21089101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health