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NPI Code Detail

MEDICARE: ELIZABETH MARIE THOMAS CADC I

MEDICARE: ELIZABETH MARIE THOMAS CADC I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCI4360615CA

General Provider Information

NPI Number : 1174996508
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MARIE THOMAS CADC I
Provider Business Mailing Address
First Line : 12890 QUINTA WAY
Second Line :
City : DESERT HOT SPRINGS
State : CA
Zip : 92240-4852
Country : US
Telephone Number : 760-329-2959
Fax Number :
Provider Business Practice Location Address
First Line : 12890 QUINTA WAY
Second Line :
City : DESERT HOT SPRINGS
State : CA
Zip : 92240-4852
Country : US
Telephone Number : 760-329-2959
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2015
Last Update Date : 11/06/2015

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