Individual
GARY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1424 S. STAPLEY DR., MESA, AZ 85204-5877
(480) 982-2356
Mailing address
6240 E SNOWDON ST, MESA, AZ 85215-9632
(602) 501-9858
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1043460397
AZ
103TC0700X
Clinical Psychologist
Primary
883
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
727943
—
AZ
Enumeration date
12/05/2006
Last updated
12/01/2009
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