Provider Demographics
NPI:1447820451
Name:FINLEY, DERRICK M
Entity type:Individual
Prefix:MR
First Name:DERRICK
Middle Name:M
Last Name:FINLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 HARVEST GROVE LN SE APT 2106
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-1857
Mailing Address - Country:US
Mailing Address - Phone:404-376-4665
Mailing Address - Fax:
Practice Address - Street 1:2106 HARVEST GROVE LN SE APT 2106
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-1857
Practice Address - Country:US
Practice Address - Phone:404-376-4665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator