Provider Demographics
NPI:1326300138
Name:THOMAS, RUTH ADELLE (APC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ADELLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 E PACIFIC DR STE B
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3132
Mailing Address - Country:US
Mailing Address - Phone:801-877-0536
Mailing Address - Fax:
Practice Address - Street 1:807 E PACIFIC DR STE B
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-3132
Practice Address - Country:US
Practice Address - Phone:801-877-0536
Practice Address - Fax:801-785-6907
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8178864-6009101YP2500X
UT8178864-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional