Individual
MR. JOHN MARK THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
750 RANSOM RD, VALPARAISO, IN 46385-8973
(219) 464-9607
Mailing address
1701 CHICAGO ST, VALPARAISO, IN 46383-5122
(219) 462-3765
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35000216A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35000216A
INDIANA PROFESSIONAL LICENSING NUMBER
IN
Enumeration date
01/29/2019
Last updated
01/29/2019
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