Provider Demographics
NPI:1487957098
Name:THOMAS, ALTHEA
Entity type:Individual
Prefix:
First Name:ALTHEA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 EDGAR CROYLE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLSOPPLE
Mailing Address - State:PA
Mailing Address - Zip Code:15935-8024
Mailing Address - Country:US
Mailing Address - Phone:406-698-6876
Mailing Address - Fax:
Practice Address - Street 1:651 S CENTER AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2811
Practice Address - Country:US
Practice Address - Phone:814-445-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health