Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103G00000X | Clinical Psychologist | 94-18P | AR |
N | 103TC0700X | Clinical Psychologist | 94-18P | AR |
Y | 103TC1900X | Counseling Psychologist | 94-18P | AR |
NPI | 1568494532 |
---|---|
Provider Name | Delbert R Thomas |
First Address | Jonesboro, AR 72401 |
Second Address | Jonesboro, AR 72401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 10/05/2017 |