Individual
MS. IDA S THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
265 BOULEVARD NE, ATLANTA, GA 30312-1208
(404) 730-1650
(404) 730-1651
Mailing address
7063 BRYCE RD, RIVERDALE, GA 30296-1953
(404) 730-0230
(404) 730-0341
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003114
GA
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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