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General NPI Number Information
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NPI Number | 1629308614
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Entity Type | Organization
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Legal Business Name | KATHY THOMAS, PH.D., P.L.L.C.
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Dates
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Enumeration Date | 01/13/2010
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 33 N LINDSAY RD SUITE 111
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City | GILBERT
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State | AZ
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Zip | 85234-5807
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Country | US
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Telephone | 480-497-6447
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Fax | 480-497-4166
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Provider Business Mailing Address
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Address Line | 33 N LINDSAY RD SUITE 111
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City | GILBERT
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State | AZ
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Zip | 85234-5807
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Country | US
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Telephone | 480-497-6447
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Fax | 480-497-4166
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Authorized Official
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Title or Position | SOLE OWNER
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Name | KATHY LEE THOMAS
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Credential | PH.D.
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Telephone | 480-497-6447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 3634
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License Number State | AZ
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