Provider Demographics
NPI:1982837050
Name:REA, THOMAS EARL (PSYD, HSPP)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EARL
Last Name:REA
Suffix:
Gender:M
Credentials:PSYD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-3559
Mailing Address - Country:US
Mailing Address - Phone:812-235-6121
Mailing Address - Fax:812-235-4565
Practice Address - Street 1:2740 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-3559
Practice Address - Country:US
Practice Address - Phone:812-235-6121
Practice Address - Fax:812-235-4565
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042342A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical