Individual
DR. THOMAS DEANTONIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1361 BLUFF DR, HAILEY, ID 83333-8895
(818) 399-7384
Mailing address
820 S MAIN ST UNIT 3671, HAILEY, ID 83333-6339
(818) 399-7384
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY14726
CA
Other
Enumeration date
03/31/2007
Last updated
11/02/2022
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