Individual
MR. BRANDON THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, PLPC
Contact information
Practice address
569 MELVILLE AVE STE 202, UNIVERSITY CITY, MO 63130-4512
(314) 762-6363
Mailing address
569 MELVILLE AVE STE 202, UNIVERSITY CITY, MO 63130-4512
(314) 762-6363
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1566009
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1566009
—
MO
Enumeration date
05/19/2021
Last updated
05/19/2021
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