Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NP596 | ME |
NPI | 1083010516 |
---|---|
Provider Name | Dr. Alicia Ann Thomas |
First Address | Topsham, ME 04086-1234 |
Second Address | Topsham, ME 04086-1234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2014 |
Last Update Date | 20/03/2020 |