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General NPI Number Information
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NPI Number | 1821019357
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Entity Type | Individual
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Provider Name | THOMAS J. MRAZ PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 08/09/2016
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Provider Practice Location Address
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Address Line | 20800 WESTGATE MALL SUITE 103
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City | FAIRVIEW PARK
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State | OH
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Zip | 44126-1323
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Country | US
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Telephone | 831-901-7790
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 45075
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City | WESTLAKE
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State | OH
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Zip | 44145-0075
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Country | US
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Telephone | 831-917-7900
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 7441
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License Number State | OH
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