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Individual
DEMETRICK DEWAYNE THOMAS
Active
Individual
DEMETRICK DEWAYNE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51592919
BCBS
AL
Enumeration date
08/25/2008
Last updated
11/18/2008
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