MEDICARE: DR. THOMAS L. MURRAY JR. PH.D.

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	5025	NC
2	106H00000X	Marriage & Family Therapist	1101	NC

General Provider Information

NPI Number	:	1972543056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS L. MURRAY JR. PH.D.

Provider Business Mailing Address
First Line	:	1533 S MAIN ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27127-2738
Country	:	US
Telephone Number	:	336-770-3277
Fax Number	:	336-770-1492

Provider Business Practice Location Address
First Line	:	1533 S MAIN ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27127-2738
Country	:	US
Telephone Number	:	336-770-3277
Fax Number	:	336-770-1492

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	08/31/2009

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