Provider Demographics
NPI:1205261476
Name:THOMAS, RICHARD MELVIN JR (BHRS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:MELVIN
Last Name:THOMAS
Suffix:JR
Gender:M
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 FEATHERSTONE RD APT 151
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-2107
Mailing Address - Country:US
Mailing Address - Phone:405-706-7482
Mailing Address - Fax:
Practice Address - Street 1:2609 FEATHERSTONE RD APT 151
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-2107
Practice Address - Country:US
Practice Address - Phone:405-706-7482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst