Provider Demographics
NPI:1548249600
Name:TOMASI, ETHEL DOREEN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ETHEL
Middle Name:DOREEN
Last Name:TOMASI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:ETHEL
Other - Middle Name:DOREEN
Other - Last Name:TOMASI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:PSC 490 PO BOX 7704
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96538
Mailing Address - Country:UM
Mailing Address - Phone:671-344-9451
Mailing Address - Fax:
Practice Address - Street 1:PSC 490 BOX 7704
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96538
Practice Address - Country:UM
Practice Address - Phone:671-344-9451
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010800891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical