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Individual
MR. THOMAS M. LANDRY
Active
Individual
MR. THOMAS M. LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW000398L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001461923
HIGHMARK BLUE CROSS
PA
Enumeration date
03/14/2006
Last updated
09/01/2009
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