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Individual
DR. KELLY DIANNE THOMAS
Active
Individual
DR. KELLY DIANNE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
30156
IL
103TC0700X
Clinical Psychologist
071.008777
IL
103TC0700X
Clinical Psychologist
Primary
29646
CA
Other
Enumeration date
06/27/2012
Last updated
03/22/2023
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