Doctor Name: | TEQUILLA THOMAS |
NPI Number: | 1184920019 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, PCC-S |
License Number: | E 0600199 SUPV |
Business Practice Address: | 1275 Nebraska Ave Toledo, OH - 436074157 |
Business Phone Number: | 4194603398 |
Business Fax Number: | |
Mailing Address: | Po Box 3117, TOLEDO |
State: | OH |
Postal Code: | 436070117 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/10/2011 |
NPI Last Update Date: | 02/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | E 0600199 SUPV |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |