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Individual

MRS. GLORIA JEAN THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
3493 WOODS EDGE DR, SUITE 103, OKEMOS, MI 48864
(517) 886-3707
(517) 349-1973
Mailing address
3493 WOODS EDGE DR, SUITE 103, OKEMOS, MI 48864
(517) 886-3707
(517) 349-1973

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801004724
MI
1041C0700X
Clinical Social Worker
6801004724
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0893685
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/22/2006
Last updated
03/03/2011
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