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Individual

MR. THOMAS RUSSELL THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, MDIV, BCC

Contact information

Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
(404) 329-2235
Mailing address
2191 ROCKBRIDGE RD, STONE MOUNTAIN, GA 30087-3588

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary

Other

Enumeration date
08/20/2006
Last updated
07/08/2007
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