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Individual

DR. THOMAS DE VRIES

Active
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Individual

DR. THOMAS DE VRIES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D

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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