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NPI Code Detail

MEDICARE: MR. TIMOTHY RAY THOMAS LMFT

MEDICARE:  MR. TIMOTHY RAY THOMAS  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist000736GA

General Provider Information

NPI Number : 1427039171
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY RAY THOMAS LMFT
Provider Business Mailing Address
First Line : 1814 CLAIRMONT RD
Second Line :
City : DECATUR
State : GA
Zip : 30033-3405
Country : US
Telephone Number : 770-402-0889
Fax Number : 404-636-7449
Provider Business Practice Location Address
First Line : 1814 CLAIRMONT RD
Second Line :
City : DECATUR
State : GA
Zip : 30033-3405
Country : US
Telephone Number : 770-402-0889
Fax Number : 404-636-7449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2005
Last Update Date : 07/08/2007

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Directions to “ MR. TIMOTHY RAY THOMAS LMFT” Practice Location

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