# THOMAS R VANFOSSEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124245576
- **Gender:** Man
- **Credential:** LMFT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | LMFT3019 | ID | Yes |

## Other

- **Enumeration date:** 04/19/2007
- **Last updated:** 12/01/2010