Individual
MR. WAYNE ARTHUR FORMICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MC LPC NCC
Contact information
Practice address
4767 E WOODSIDE WAY, GILBERT, AZ 85297-7479
(602) 561-5286
Mailing address
4767 E WOODSIDE WAY, GILBERT, AZ 85297-7479
(602) 561-5286
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10413
AZ
Other
Enumeration date
05/28/2019
Last updated
05/28/2019
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