Doctor Name: | ELAINE STUART-THOMS |
NPI Number: | 1285714659 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LPC |
License Number: | 000492 |
Business Practice Address: | 25 W Lakeview Dr Granby, CT - 060351418 |
Business Phone Number: | 8606530682 |
Business Fax Number: | 8606530682 |
Mailing Address: | 25 W Lakeview Dr, GRANBY |
State: | CT |
Postal Code: | 060351418 |
Phone Number: | 8606530682 |
Fax Number: | 8606530682 |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 000492 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |