NPI 1154564185 · live from the CMS NPI Registry
Thomas Wesley Ayala, Licensed Counselor
Psychologist in Lebanon, OR. National Provider Identifier 1154564185, active.
NPI record
| NPI | 1154564185 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist 103T00000X |
| Practice location | 880 Main St, Lebanon, OR 97355 |
| Practice phone | 541-258-8210 |
| Mailing address | Po Box 280, Lebanon, OR 97355 |
| Enumerated | April 7, 2009 |
| Last updated | December 29, 2016 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional | 101YP2500X | C1962 (OR) |
| Psychologist primary | 103T00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.