Individual
THOMAS GILLETTE SOULE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1 EDGERTON PARK, ROCHESTER, NY 14608-1054
(585) 787-0963
Mailing address
1 EDGERTON PARK, ROCHESTER, NY 14608-1054
(585) 787-0963
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
P044396-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P044396-1
—
NY
Enumeration date
09/22/2011
Last updated
10/25/2011
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