Organization
MARY GRACE THOMAS, PH.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY GRACE THOMAS PH.D. (LICENSED PSYCHOLOGIST)
(678) 714-9590
Entity
Organization
Contact information
Practice address
4411 SUWANEE DAM RD, SUITE 920, SUWANEE, GA 30024-8701
(678) 714-9590
(678) 714-9535
Mailing address
4411 SUWANEE DAM RD, SUITE 920, SUWANEE, GA 30024-8701
(678) 714-9590
(678) 714-9535
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1806
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00614545A
—
GA
Enumeration date
10/13/2009
Last updated
10/13/2009
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