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MRS. GENEVIEVE LAFAYE THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
199 W BRIDGE ST, BLACKFOOT, ID 83221-2704
(208) 782-2060
(208) 782-0209
Mailing address
7800 OLD RECEIVER RD, FREDERICK, MD 21702-2757
(208) 241-3660

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-27708
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806855600
ID
Enumeration date
11/08/2006
Last updated
07/31/2019
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