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Individual

MR. THOMAS DEAN HOLTGREWE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
5960 DEARBORN ST STE 1, MISSION, KS 66202-3362
(913) 645-6652
(913) 362-6410
Mailing address
5960 DEARBORN ST STE 1, MISSION, KS 66202-3362
(913) 645-6652
(913) 362-6410

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
309
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A880171
BLUE CROSS BLUE SHIELD KANSAS CITY MISSOURI
MO
Enumeration date
12/29/2009
Last updated
12/29/2009
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