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General NPI Number Information
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NPI Number | 1083448971
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Entity Type | Organization
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Legal Business Name | THAICOUNSELOR P.C.
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Dates
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Enumeration Date | 09/02/2024
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 825 9TH ST STE A
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City | MARYSVILLE
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State | CA
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Zip | 95901-5246
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Country | US
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Telephone | 844-816-1777
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Fax | 866-473-2566
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Provider Business Mailing Address
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Address Line | 1021 E LINCOLNWAY UNIT 768
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City | CHEYENNE
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State | WY
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Zip | 82001-4851
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Country | US
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Telephone | 844-816-1777
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Fax | 866-473-2566
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Authorized Official
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Title or Position | PARTNER
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Name | MS. LAURA SMITH
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Credential | LMFT
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Telephone | 844-816-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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