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General NPI Number Information
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NPI Number | 1942739115
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Entity Type | Individual
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Provider Name | THURMON ELDON THOMAS LAMFT
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Gender | Male
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Dates
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Enumeration Date | 06/09/2017
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Last Update Date | 06/09/2017
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Provider Practice Location Address
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Address Line | 321 N MALL DRIVE VW 101
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City | SAINT GEORGE
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State | UT
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Zip | 84790
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Country | US
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Telephone | 435-862-6831
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Fax |
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Provider Business Mailing Address
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Address Line | 2147 ALVEO DR
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City | WASHINGTON
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State | UT
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Zip | 84780-8137
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Country | US
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Telephone | 435-862-6831
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 5819973-3904
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License Number State | UT
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