Individual provider · Type 1 NPI

Greg David Thedell, BSW

Mental Health Counselor · San Diego, CA

NPI number 1124349394 Active

Practice location

9445 Farnham St, Suite 100
San Diego, CA 92123-1308

Mailing address

4174 Mandarin Ter
San Diego, CA 92115-6053

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1124349394

Greg David Thedell, BSW's National Provider Identifier is 1124349394, issued on Jun 22, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Diego, CA. The record was last updated on Jun 22, 2010.