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Individual
THOMAS DE VITIS JR.
Active
Individual
THOMAS DE VITIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
PA
101YP2500X
Professional Counselor
Primary
PC013103
PA
Other
Enumeration date
06/24/2019
Last updated
04/29/2024
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