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Individual

MR. BRYAN K THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPCC

Contact information

Practice address
125 LA POSTA RD, TAOS, NM 87571-7240
(575) 737-8189
Mailing address
PO BOX 33, TAOS, NM 87571-0033
(575) 224-1311

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
251S00000X
Community/Behavioral Health Agency
0152331
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06525075
NM
Enumeration date
03/24/2007
Last updated
07/20/2022
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