Doctor Name: | MS. BETTY J THOMAS |
NPI Number: | 1699864017 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CADC |
License Number: | 6068 |
Business Practice Address: | 2332 S 22nd Ave Broadview, IL - 601553805 |
Business Phone Number: | 7082023652 |
Business Fax Number: | 7082027013 |
Mailing Address: | 2332 S 22nd Ave, BROADVIEW |
State: | IL |
Postal Code: | 601553805 |
Phone Number: | 7082023652 |
Fax Number: | 7082027013 |
NPI Enumeration Date: | 10/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 6068 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |