Kerley, Thomas J

Kerley, Thomas J is an individual health care provider with primary practice located at 1000 E Aztec Ave , Gallup NM 87301-5509. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Kerley, Thomas J can be contacted via phone (505) 721-1872.

Contact Information

Primary practice address
1000 E Aztec Ave Gallup NM 87301-5509
Phone: (505) 721-1872
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X B-1192 New Mexico

Profile Details

NPI number 1942494836
LBN Legal business name Kerley, Thomas J
Credentials LBSW
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 4th, 2007
Last updated Sep 4th, 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 1942494836 NPPES
New Mexico MEDICAID B-1192

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