| Doctor Name: | DR. FREDRICK ANTONIA THRASHER |
| NPI Number: | 1033354212 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD, LPC, NCC |
| License Number: | 004599 |
| Business Practice Address: | 110 Eagle Spring Dr Ste D Stockbridge, GA - 302816488 |
| Business Phone Number: | 6785651400 |
| Business Fax Number: | 8669459685 |
| Mailing Address: | 110 Eagle Spring Dr Ste D, STOCKBRIDGE |
| State: | GA |
| Postal Code: | 302816488 |
| Phone Number: | 6785651400 |
| Fax Number: | 8669459685 |
| NPI Enumeration Date: | 12/02/2008 |
| NPI Last Update Date: | 07/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 004599 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |