Provider Demographics
NPI:1871786228
Name:FINTON, MARK (PH D)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:FINTON
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 E POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:SELMER
Mailing Address - State:TN
Mailing Address - Zip Code:38375-1828
Mailing Address - Country:US
Mailing Address - Phone:731-645-5753
Mailing Address - Fax:731-645-9885
Practice Address - Street 1:641 E POPLAR AVE
Practice Address - Street 2:
Practice Address - City:SELMER
Practice Address - State:TN
Practice Address - Zip Code:38375-1828
Practice Address - Country:US
Practice Address - Phone:731-645-5753
Practice Address - Fax:731-645-9885
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor