Individual
TINA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1860 W GLADE CREEK ST, MERIDIAN, ID 83646-4310
(208) 941-3142
Mailing address
1860 W GLADE CREEK ST, MERIDIAN, ID 83646-4310
(208) 941-3142
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6182
ID
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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