Provider Demographics
NPI:1932261781
Name:THOMAS, JOHN H (EDD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:THOMAS
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:H
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD
Mailing Address - Street 1:1420 E MCMILLAN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2225
Mailing Address - Country:US
Mailing Address - Phone:513-961-5682
Mailing Address - Fax:513-961-2441
Practice Address - Street 1:1420 E MCMILLAN ST STE 1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2225
Practice Address - Country:US
Practice Address - Phone:513-961-5682
Practice Address - Fax:513-961-2441
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4123103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling