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General NPI Number Information
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NPI Number | 1982923769
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Entity Type | Individual
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Provider Name | MR. THOMAS F LETSON
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Gender | Male
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 03/25/2014
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Provider Practice Location Address
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Address Line | 25 KENNEDY BLVD STE 600
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-1262
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Country | US
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Telephone | 732-547-2603
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Fax |
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Provider Business Mailing Address
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Address Line | 143 TANGERINE DR
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City | MARLBORO
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State | NJ
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Zip | 07746-1855
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Country | US
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Telephone | 732-547-2603
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00095800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37PC00170000
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License Number State | NJ
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