MEDICARE: THOMAS M LABRECHE PHD PLLC

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
1	103TC0700X	Clinical Psychologist	NC1084	NC

General Provider Information

NPI Number	:	1841738440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS M LABRECHE PHD PLLC

Provider Business Mailing Address
First Line	:	PO BOX 1741
Second Line	:
City	:	RUTHERFORDTON
State	:	NC
Zip	:	28139-1741
Country	:	US
Telephone Number	:	828-395-2510
Fax Number	:	828-395-2511

Provider Business Practice Location Address
First Line	:	487 WEST ST
Second Line	:
City	:	SPINDALE
State	:	NC
Zip	:	28160-1357
Country	:	US
Telephone Number	:	828-395-2510
Fax Number	:	828-395-2511

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	THOMAS M LABRECHE
Credential	:	PHD
Telephone Number	:	828-395-2510

Provider Enumeration Date	:	02/03/2017
Last Update Date	:	02/03/2017

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