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Individual
JERRY EDWARD THOMAS
Active
Individual
JERRY EDWARD THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICDC-CS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCIII.161573
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.161973
OH
171M00000X
Case Manager/Care Coordinator
LICDC.161973
OH
Other
Enumeration date
08/22/2017
Last updated
02/21/2024
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