Wayne A. Formica
NPI #1902092422 in Queen Creek, Arizona
Provider Information
- NPI Number
- 1902092422
- Entity Type
- Organization
- Organization Name
- Wayne A. Formica
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Sep 18, 2007
- Last Updated
- Sep 18, 2007
Practice Location
- Address
- 2055 W FRUIT TREE LN
- City
- Queen Creek
- State
- Arizona
- ZIP Code
- 85242-6356
- Phone
- (480) 677-4804
Authorized Official
- Name
- MR. WAYNE ARTHUR FORMICA, LPC
- Title
- LICENSED PROFESSIONAL COUNSELOR
- Phone
- (480) 677-4804
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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