Provider Demographics
NPI:1912035379
Name:EMBREE, THOMAS J (MFT,PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:EMBREE
Suffix:
Gender:M
Credentials:MFT,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 JONES RANCH RD
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89460-6304
Mailing Address - Country:US
Mailing Address - Phone:775-781-3671
Mailing Address - Fax:775-782-7274
Practice Address - Street 1:1528 HIGHWAY 395
Practice Address - Street 2:SUITE 100
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89423
Practice Address - Country:US
Practice Address - Phone:775-781-3671
Practice Address - Fax:775-782-7274
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0207106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist