Healthcare Provider Details

I. General information

NPI: 1336056886
Provider Name (Legal Business Name): DWAN LEKEEFE FINNEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14765 W MOUTAIN VIEW BLVD SUITE 107
SURPRISE AZ
85374
US

IV. Provider business mailing address

300 INTERNATIONAL PKWY STE 200
LAKE MARY FL
32746
US

V. Phone/Fax

Practice location:
  • Phone: 480-751-1957
  • Fax:
Mailing address:
  • Phone: 866-611-1558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: