Healthcare Provider Details

I. General information

NPI: 1497272454
Provider Name (Legal Business Name): BRANDY R FINFROCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E MAIN ST
GREENVILLE OH
45331-1913
US

IV. Provider business mailing address

409 S MELVIN ELEY AVE
UNION CITY OH
45390-8611
US

V. Phone/Fax

Practice location:
  • Phone: 937-548-1635
  • Fax:
Mailing address:
  • Phone: 765-969-6005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: