Provider Demographics
NPI:1518442318
Name:THOMAS, GENEVIEVE TEMPY
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:TEMPY
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4932 BATTLE FOREST CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-0963
Mailing Address - Country:US
Mailing Address - Phone:901-310-7358
Mailing Address - Fax:
Practice Address - Street 1:3900 COVINGTON PIKE
Practice Address - Street 2:SUITE 107
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128
Practice Address - Country:US
Practice Address - Phone:907-213-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health