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General NPI Number Information
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NPI Number | 1831335942
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Entity Type | Organization
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Legal Business Name | THOMAS J. GILLIGAN, PH.D., P.C.
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 12/18/2008
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Provider Practice Location Address
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Address Line | 8101 O ST SUITE 214
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City | LINCOLN
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State | NE
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Zip | 68510-2646
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Country | US
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Telephone | 402-488-1032
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Fax | 402-484-8545
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Provider Business Mailing Address
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Address Line | 706 MAPLE DR
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City | EAGLE
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State | NE
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Zip | 68347-2110
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Country | US
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Telephone | 402-781-1122
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Fax | 402-781-1122
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS J. GILLIGAN
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Credential | PH.D.
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Telephone | 402-488-1032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 171
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License Number State | NE
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