| Doctor Name: | MR. THOMAS J. STREB |
| NPI Number: | 1073754842 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 4620 |
| Business Practice Address: | 3019 County Complex Dr Canandaigua, NY - 144249505 |
| Business Phone Number: | 5853964190 |
| Business Fax Number: | 5853932916 |
| Mailing Address: | 3019 County Complex Dr, CANANDAIGUA |
| State: | NY |
| Postal Code: | 144249505 |
| Phone Number: | 5853964190 |
| Fax Number: | 5853932916 |
| NPI Enumeration Date: | 03/09/2009 |
| NPI Last Update Date: | 03/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 4620 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |