Provider Demographics
NPI:1689996217
Name:THOMI, SUE ANN
Entity Type:Individual
Prefix:MS
First Name:SUE
Middle Name:ANN
Last Name:THOMI
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 1:1445 ELK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75253-2902
Mailing Address - Country:US
Mailing Address - Phone:972-754-1950
Mailing Address - Fax:972-557-8591
Practice Address - Street 1:400 S ZANG BLVD
Practice Address - Street 2:SUITE # 813
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-6600
Practice Address - Country:US
Practice Address - Phone:972-754-1950
Practice Address - Fax:972-557-8591
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20222101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional