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Individual
MR. THOMAS JAMES BOTTLE
Active
Individual
MR. THOMAS JAMES BOTTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
082884-1
NY
1041C0700X
Clinical Social Worker
088032-1
NY
Other
Enumeration date
07/30/2012
Last updated
08/02/2019
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