Provider Demographics
NPI:1316307622
Name:GIBSON & THOMAS BEHAVIROL HEALTH CONSULTANTS
Entity type:Organization
Organization Name:GIBSON & THOMAS BEHAVIROL HEALTH CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-370-8544
Mailing Address - Street 1:4103 FOX HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-2041
Mailing Address - Country:US
Mailing Address - Phone:410-370-8544
Mailing Address - Fax:
Practice Address - Street 1:4103 FOX HOLLOW LN
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-2041
Practice Address - Country:US
Practice Address - Phone:410-370-8544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management