Wayne A. Formica
Wayne A. Formica is a Community/Behavioral Health Agency in Queen Creek, Arizona. Licensed in Arizona. Registered with an NPI since 2007.
- Licensed in
- AZ
- In the registry since
- 2007
Practice location Address may be wrong
2055 W Fruit Tree LnQueen Creek, AZ 85242-6356
Phone: (480) 677-4804
Fax: (480) 677-4804
No coordinates on file. Search this address in Google Maps
Specialties & licences
| Community/Behavioral Health Agency (primary) | Taxonomy 251S00000X · Licence LPC 10413 (AZ) |
|---|
Record details
| NPI number | 1902092422 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Wayne Formica — Licensed Professional Counselor · (480) 677-4804 |
| NPI enumerated | September 18, 2007 |
| Last updated in NPPES | September 18, 2007 |
| Mailing address | 2055 W Fruit Tree Ln, Queen Creek, AZ 85242-6356 |
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