Organization
DR. EVAN THOMAS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVAN THOMAS (LICENSED PSYCHOLOGIST)
(510) 566-2367
Entity
Organization
Contact information
Practice address
2470 WINDY HILL RD SE STE 362, MARIETTA, GA 30067-8613
(404) 418-8168
Mailing address
25857 FOOTHILLS DR N, GOLDEN, CO 80401-8556
(510) 566-2367
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PSY003899
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003171129A
—
GA
Enumeration date
02/22/2018
Last updated
02/22/2018
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