MEDICARE: DR. THOMAS JOHN PETRE' WILLS PHD

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
1	103TS0200X	School Psychologist	0675463	VA

General Provider Information

NPI Number	:	1598695744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS JOHN PETRE' WILLS PHD

Provider Business Mailing Address
First Line	:	2893 COLLIERSTOWN RD
Second Line	:
City	:	LEXINGTON
State	:	VA
Zip	:	24450-6811
Country	:	US
Telephone Number	:	540-463-7386
Fax Number	:	540-463-7823

Provider Business Practice Location Address
First Line	:	2893 COLLIERSTOWN RD
Second Line	:
City	:	LEXINGTON
State	:	VA
Zip	:	24450-6811
Country	:	US
Telephone Number	:	540-463-7386
Fax Number	:	540-463-7823

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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