Deters, Thomas John

Deters, Thomas John is an sole proprietor health care provider with primary practice located at 1753 Massachusetts Ave , Cambridge MA 02140-2231. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Deters, Thomas John can be contacted via phone (617) 661-7516.

Contact Information

Primary practice address
1753 Massachusetts Ave Cambridge MA 02140-2231
Phone: (617) 661-7516
Fax: (617) 661-7516
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 3637 Massachusetts
Behavioral Health & Social Service Providers / Psychologist 103T00000X 353 New Hampshire
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 3637 Massachusetts
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3637 Massachusetts
Behavioral Health & Social Service Providers / Forensic 103TF0200X 3637 Massachusetts

Profile Details

NPI number 1851376578
LBN Legal business name Deters, Thomas John
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 15th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851376578 NPPES
Other W03667 BCBS

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