| Thomas E Holsworth | |
|
4201 Mannheim Rd Suite G Jasper IN 47546-9617 | |
| (812) 481-9988 | |
| (812) 481-9989 |
| Full Name | Thomas E Holsworth |
|---|---|
| Speciality | Psychologist |
| Location | 4201 Mannheim Rd, Jasper, Indiana |
| Authorized Official Name and Position | Melissa M Umali (OWNER) |
| Authorized Official Contact | 8124819988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas E Holsworth 4201 Mannheim Rd Suite G Jasper IN 47546-9617 Ph: (812) 481-9988 | Thomas E Holsworth 4201 Mannheim Rd Suite G Jasper IN 47546-9617 Ph: (812) 481-9988 |
| NPI Number | 1225206584 |
|---|---|
| Provider Enumeration Date | 02/20/2008 |
| Last Update Date | 07/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225206584 | NPI | - | NPPES |
| 100383740A | Medicaid | IN | |
| 100109690A | Medicaid | IN | |
| 200463710A | Medicaid | IN | |
| 200463500A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 20090206 (Indiana) | Secondary |
| 103T00000X | Psychologist | 20090206 (Indiana) | Primary |
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