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Individual
THOMAS AVERY
Active
Individual
THOMAS AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801093030
MI
1041C0700X
Clinical Social Worker
6801093030
MI
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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