Doctor Name: | MR. TROY NOLAN THOMAS |
NPI Number: | 1184084113 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RSW |
License Number: | 12108 |
Business Practice Address: | 4012 Carter St. Vidalia, LA - 71373 |
Business Phone Number: | 6018705868 |
Business Fax Number: | |
Mailing Address: | 628 Concordia Pk, VIDALIA |
State: | LA |
Postal Code: | 713733730 |
Phone Number: | 6018705868 |
Fax Number: | |
NPI Enumeration Date: | 03/03/2016 |
NPI Last Update Date: | 03/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 12108 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |