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General NPI Number Information
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NPI Number | 1508298423
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Entity Type | Individual
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Provider Name | DUANE EDWARD THOMAS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 405 FREDERICK ROAD SUITE 158
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City | CATONSVILLE
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State | MD
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Zip | 21228-4633
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Country | US
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Telephone | 410-747-1265
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Fax | 410-744-7981
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Provider Business Mailing Address
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Address Line | 405 FREDERICK ROAD SUITE 158
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City | CATONSVILLE
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State | MD
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Zip | 21228-4633
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Country | US
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Telephone | 410-747-1265
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Fax | 410-744-7981
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 05557
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 05557
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License Number State | MD
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