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Contact Information

THOMAS DE VRIES, PhD
405 W COUTRY CLUB RD
ROSWELL, NM88201-5209
 Phone: 505-273-0574
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health

103TH0004X 62 Psychologist, Clinical
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for THOMAS DE VRIES · (Male)

NPI Number 1700200722
Status Active
Credentials PhD
Entity Individual
Enumeration date 02/11/2014
Last updated 10/21/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • NM License # 0047C
  • NM License # 1233
  • NM Other 1233 NM STATE BOARD OF PSYCHOLOGIST EXAMINERS LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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