Provider Demographics
NPI:1023345246
Name:THOMAS, NINA (COUNSELOR-PEDUCATOR)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:COUNSELOR-PEDUCATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 BEACON ST
Mailing Address - Street 2:WOMENS & CHILDRENS PROGRAM-MORRIS FOUNDATION, INC
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06704-3424
Mailing Address - Country:US
Mailing Address - Phone:203-574-3311
Mailing Address - Fax:203-574-3315
Practice Address - Street 1:402 EAST MAIN STREET
Practice Address - Street 2:MORRIS FOUNDATION, INC
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1701
Practice Address - Country:US
Practice Address - Phone:203-755-1143
Practice Address - Fax:203-755-1447
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional