Provider Demographics
NPI:1104043934
Name:THOMART, DANA BRIGALE (MFT)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:BRIGALE
Last Name:THOMART
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 GRAND AVE
Mailing Address - Street 2:A-10
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1808
Mailing Address - Country:US
Mailing Address - Phone:760-729-0297
Mailing Address - Fax:760-729-0027
Practice Address - Street 1:800 GRAND AVE
Practice Address - Street 2:A-10
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1808
Practice Address - Country:US
Practice Address - Phone:760-729-0297
Practice Address - Fax:760-729-0027
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42763106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist