Doctor Name: | MR. THOMAS D. THOMAS |
NPI Number: | 1225237860 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, LPC, CSAT |
License Number: | 1246-125 |
Business Practice Address: | 416 George St Suite Ll6 De Pere, WI - 541152712 |
Business Phone Number: | 9203380331 |
Business Fax Number: | 9203380348 |
Mailing Address: | 416 George St, Suite Ll6 DE PERE |
State: | WI |
Postal Code: | 541152712 |
Phone Number: | 9203380331 |
Fax Number: | 9203380348 |
NPI Enumeration Date: | 07/13/2007 |
NPI Last Update Date: | 01/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1246-125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |