Individual
MR. THOMAS BAUGHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.I.S.A.C.
Contact information
Practice address
5767 RUTH DR, FORT MOHAVE, AZ 86426-8828
(928) 768-3506
Mailing address
5767 RUTH DR, FORT MOHAVE, AZ 86426-8828
(928) 768-3506
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC 10256
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LISAC 10256
AZBBHE
AZ
Enumeration date
03/25/2008
Last updated
03/25/2008
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