Doctor Name: | GENEVIEVE THOMAS |
NPI Number: | 1831426501 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCA |
License Number: | KY-0951 |
Business Practice Address: | 112 Sartin Dr Edmonton, KY - 421298170 |
Business Phone Number: | 2704324951 |
Business Fax Number: | 2704325054 |
Mailing Address: | 112 Sartin Dr, EDMONTON |
State: | KY |
Postal Code: | 421298170 |
Phone Number: | 2704324951 |
Fax Number: | 2704325054 |
NPI Enumeration Date: | 11/17/2009 |
NPI Last Update Date: | 11/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | KY-0951 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |