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General NPI Number Information
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NPI Number | 1225660913
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Entity Type | Individual
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Provider Name | WINAND J THOMAS JR. RBT
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Gender | Male
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Dates
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Enumeration Date | 02/10/2020
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Last Update Date | 02/10/2020
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Provider Practice Location Address
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Address Line | 685 RIVER AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5288
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Country | US
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Telephone | 732-367-3667
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Fax |
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Provider Business Mailing Address
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Address Line | 79 POTOMAC AVE SE APT 730
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City | WASHINGTON
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State | DC
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Zip | 20003-3696
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Country | US
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Telephone | 504-427-9773
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-79772
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License Number State | LA
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