Individual provider · Type 1 NPI

Keith William Tom

Mental Health Counselor · Truckee, CA

NPI number 1104578897 Active

Practice location

10038 Meadow Way Unit D
Truckee, CA 96161-4974

Mailing address

2604 Armstrong Ave
South Lake Tahoe, CA 96150-2941

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1104578897

Keith William Tom's National Provider Identifier is 1104578897, issued on Jan 24, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Truckee, CA. The record was last updated on Jan 24, 2022.