Doctor Name: | GUY RONALD FINICUM |
NPI Number: | 1265556336 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | LPC-12447 |
Business Practice Address: | 465 South Main Fredonia, AZ - 860220710 |
Business Phone Number: | 9286436000 |
Business Fax Number: | 9286436024 |
Mailing Address: | Po Box 528, FREDONIA |
State: | AZ |
Postal Code: | 860220528 |
Phone Number: | 4358991312 |
Fax Number: | 9286436024 |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 10/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC-12447 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |