Individual
DR. THOMAS E HOLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., HSPP
Contact information
Practice address
4201 MANNHEIM RD SIDE G, JASPER, IN 47546-9617
(812) 481-9988
(812) 481-9989
Mailing address
4201 MANNHEIM RD SIDE G, JASPER, IN 47546-9617
(812) 481-9988
(812) 481-9989
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20090206A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100109690A
—
IN
Enumeration date
12/30/2005
Last updated
07/08/2007
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