| NPI | 1548460439 |
|---|---|
| Former Name | SUSAN THOMAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: KS 011) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KS 050) |
| 103T00000X Psychologist (Licence: KS 2811) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2020-09-14 |