Individual
MR. KENNETH T. THOM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
515 W COOPER ST, MARYVILLE, MO 64468-2417
(660) 562-2531
(660) 562-3239
Mailing address
515 W COOPER ST, MARYVILLE, MO 64468-2417
(660) 562-2531
(660) 562-3239
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002237
MO
Other
Enumeration date
12/13/2005
Last updated
07/09/2007
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