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Individual

DR. THOM DANIEL BALMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
901 EAST 16TH STREET, ARBUCKLE LIFE SOLUTIONS, ADA, OK 74820
(580) 226-1656
Mailing address
901 EAST 16TH STREET, ARBUCKLE LIFE SOLUTIONS, ADA, OK 74820
(580) 559-5839

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1028
OK
101YP2500X
Professional Counselor
1028
OK
106H00000X
Marriage & Family Therapist
Primary
699
OK

Other

Enumeration date
01/03/2007
Last updated
07/13/2011
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