Individual
THERESA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4103 FOX HOLLOW LN, RANDALLSTOWN, MD 21133-2041
(410) 340-8544
Mailing address
4103 FOX HOLLOW LANE, RANDALLSTOWN, MD 21133-2416
(410) 370-8544
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC1484
MD
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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