Individual
TIMOTHY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
8435 HOLLY RD, GRAND BLANC, MI 48439-1812
(810) 424-2400
(810) 579-7222
Mailing address
3495 S CENTER RD, BURTON, MI 48519-1455
(810) 424-2007
(810) 743-1099
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401004259
MI
Other
Enumeration date
09/01/2006
Last updated
09/20/2007
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