Individual
DR. THOMAS DE VRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
405 W COUTRY CLUB RD, ROSWELL, NM 88201-5209
(505) 273-0574
Mailing address
706 N PENNSYLVANIA AVE, ROSWELL, NM 88201
Taxonomy
Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
Primary
1233
NM
103TP0016X
Prescribing (Medical) Psychologist
0047C
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1233
NM STATE BOARD OF PSYCHOLOGIST EXAMINERS LICENSE
NM
Enumeration date
02/11/2014
Last updated
10/21/2022
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