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1114321478
MATHEW THOMAS
TISHOMINGO, OK
NPI
1114321478
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Additional Taxonomies
251S00000X
Enumeration Date
2014-10-15
Last Update Date
2014-10-15
Business Address
-- MATHEW THOMAS
801 E MAIN ST
TISHOMINGO, OK 73460-2351
Phone number: 571-331-7374
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Mailing Address
-- MATHEW THOMAS
3722 HERITAGE PARK DR
SACHSE, TX 75048-4741
Phone number: 571-331-7374
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