Basic Information
| Provider Information | |||||||||
| NPI: | 1497272454 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FINFROCK | ||||||||
| FirstName: | BRANDY | ||||||||
| MiddleName: | R | ||||||||
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| Mailing Information | |||||||||
| Address1: | 409 S MELVIN ELEY AVE | ||||||||
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| City: | UNION CITY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453908611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7659696005 | ||||||||
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| Practice Location | |||||||||
| Address1: | 212 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453311913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9375481635 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2017 | ||||||||
| LastUpdateDate: | 08/29/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | C.1700629 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.