Individual
TIMOTHY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
542 4TH AVE STE B101, FAIRBANKS, AK 99701-4707
(907) 374-1097
Mailing address
1087 TAZLINA CT, FAIRBANKS, AK 99701-1421
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/08/2019
Last updated
03/06/2020
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