Healthcare Provider Details

I. General information

NPI: 1457373912
Provider Name (Legal Business Name): JON V THOMAS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 ARCH ST. SUITE 3A
AKRON OH
44304-1447
US

IV. Provider business mailing address

13383 THEELAND AVE NW
UNIONTOWN OH
44685-9393
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3761
  • Fax: 330-375-4291
Mailing address:
  • Phone: 330-375-3761
  • Fax: 330-375-4291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3095
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: