Provider Demographics
NPI:1801521406
Name:THOMAS, EMILY BRENNY KROSKA (PHD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:BRENNY KROSKA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:BRENNY
Other - Last Name:KROSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:340 IOWA AVENUE
Mailing Address - Street 2:G60 PBSB
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242
Mailing Address - Country:US
Mailing Address - Phone:319-467-1691
Mailing Address - Fax:
Practice Address - Street 1:335 E. JEFFERSON ST.
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-335-2467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA097080103TH0100X
IA097020103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service