Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor |
NPI | 1003186685 |
---|---|
Provider Name | Ashley Nichole Thomas |
First Address | Eureka, CA 95501-3325 |
Second Address | Eureka, CA 95501-3325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2012 |
Last Update Date | 31/10/2016 |