MEDICARE: JAYANT THOMAS

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	101YP2500X	Professional Counselor	E0008316	OH

General Provider Information

NPI Number	:	1932951910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYANT THOMAS

Provider Business Mailing Address
First Line	:	1556 CHARMAINE DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2560
Country	:	US
Telephone Number	:	419-466-9659
Fax Number	:

Provider Business Practice Location Address
First Line	:	1556 CHARMAINE DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2560
Country	:	US
Telephone Number	:	419-466-9659
Fax Number	:

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

Provider Enumeration Date	:	04/03/2024
Last Update Date	:	04/03/2024

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Directions to “ JAYANT THOMAS ” Practice Location

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