Individual
DALE RUSSELL THOMAS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
131 MARKET ST, JOHNSTOWN, PA 15901-1628
(814) 535-2277
Mailing address
1765 GOUCHER ST, STE 150, JOHNSTOWN, PA 15905-1101
(814) 535-8586
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/18/2007
Last updated
08/17/2016
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