Individual
DEMETRICK DEWAYNE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
2409 HOMER CLAYTON DR, GUNTERSVILLE, AL 35976-2207
(256) 582-3203
(256) 582-3216
Mailing address
1241 OBRIG AVE, GUNTERSVILLE, AL 35976-1430
(256) 582-4240
(256) 582-4161
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51592919
BCBS
AL
Enumeration date
08/25/2008
Last updated
11/18/2008
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