Doctor Name: | DR. THOMAS S STANAGE |
NPI Number: | 1174506505 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 342 |
Business Practice Address: | 1028 Walnut Lewis & Clark Bhs Yankton, SD - 57078 |
Business Phone Number: | 6056654606 |
Business Fax Number: | 6056654673 |
Mailing Address: | 1028 Walnut, YANKTON |
State: | SD |
Postal Code: | 57078 |
Phone Number: | 6056654606 |
Fax Number: | 6056654673 |
NPI Enumeration Date: | 11/21/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 342 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |